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Open Ultimate Challenge 2011

Registration form
TEAM: ____________________
NO. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. NAME I/C NO.

NO. 1 2 3 CONTACT NUMBER E-MAIL ADDRESS

MANAGERS NAME

IC NUMBER

HP:

OFFICE:

FOR ORGANIZER USE. NAME : POSITION : DATE: TOTAL PAYMENT

RM 150

Disclaimer: I understand the risk of mortal or serious personal injuries or property damage through accidents involving terrain and weather are beyond the control of the organizers. In consideration of the acceptance of my application to participate in this event, I hereby waive and release any and all rights and claims for damages may have against the organizers, their members, associates, sponsors, promoters or volunteers involved with the event. I agree and obey all event rules.

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