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Full Name
Residential Address
Active Email Address
*wajib diisi untuk konfirmasi pendaftaran
Active WhatsApp Number
BIB Name (Max. 10 Characters)
Gender
Jenis Kelamin
Male (Laki-Laki)
Female (Perempuan)
Blood Type
Golongan Darah
A
AB
B
O
Emergency Contact Name
Emergency Contact Number
Emergency Contact Relationship
Hubungan Kontak Darurat Dengan Peserta
Parents (Orang Tua)
Sibling / Relative (Saudara)
Spouse / Partner (Pasangan)
Friend (Teman)
Jersey Size
Size Jersey
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Adult Size - XS
Adult Size - S
Adult Size - M
Adult Size - L
Adult Size - XL
Adult Size - XXL
Adult Size - 3XL
Kids Size - XS
Kids Size - S
Kids Size - M
Kids Size - L
Kids Size - XL
Kids Size - XXL
I declare that I am in good health and agree to be personally responsible for my own health risks.
Saya dalam kondisi sehat dan bersedia menanggung risiko kesehatan secara mandiri.
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