ENTRY FORM / BORANG PENYERTAAN

NAME (in BLOCK letters) / NAMA PENUH (dalam HURUF BESAR)

..........................................................................................................................................................................
NATIONALITY / WARGANEGARA .....................................................................................................................
ADDRESS (in BLOCK letters) / ALAMAT (dalam HURUF BESAR)
.......................................................................................................................................................................... Charity Walk in support of World Hunger Relief 2010
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POSTCODE / POSKOD ....................................................................................................................................

JOIN THE WALK

TELEPHONE NO ........................................................ MOBILE NO .................................................................
EMAIL ............................................................. AGE / UMUR ........................ SEX / JANTINA .........................
I.C./ PASSPORT NO. / NO. K.P./ PASPOT ........................................................................................................
DATE OF BIRTH / TARIKH LAHIR (DDMMYY) .................................................................................................... Attractive prizes and
IN AN EMERGENCY, PLEASE CONTACT / SEKIRANYA BERLAKU KECEMASAN, SILA HUBUNGI
NAME / NAMA .................................................................................................................................................. goodies await you! Saturday, 30 October 2010
TELEPHONE NO .............................................. RELATIONSHIP / HUBUNGAN ..............................................

DECLARATION / PENGIKTIRAFAN SIZE CHART Istana Kehakiman, Presint 3, Putrajaya

I declare that I am entering the ‘Be The Movement’ - TICK YOUR T-SHIRT SIZE FOR
charity walk at my own risk and shall not hold the
Organisers responsible for any injury, accident or
OUR DATABASE COLLECTION
CARTA SAIZ
from 5.00 pm onwards
death, howsoever caused before, during or after - TANDAKAN SAIZ BAJU ANDA
the walk. My age is calculated from my identity card/ UNTUK PUNGUTAN DATA KAMI
birth certificate and is given correctly as above. / Saya
mengakui bahawa saya menyertai jalan kaki amal ADULT SIZES
‘Be The Movement’ ini di atas risiko sendiri terhadap
XS S M L XL 2XL 3XL
sebarang kecederaan, kemalangan atau kematian atas
sebarang sebab sebelum, semasa atau selepas acara

ration
ini. Umur saya adalah menurut kad pengenalan/ surat
beranak diri dan adalah betul seperti yang diberi di atas. KID SIZES
Regist
only
S M L XL 2XL
Fee is
RM20die
DECLARATION FOR PARTICIPANT’S T-SHIRT /
PENGIKTIRAFAN BAJU PESERTA

oo
I am aware that the size availability of the T-shirt is based
on a first come, first served basis. / Saya sedia maklum
with G ded
clu
Bag in
bahawa saiz baju larian adalah terhad untuk mereka
yang mendapatkannya selagi stok masih ada.

Signature / Tandatangan: ........................................

(Participant / Peserta)
Date / Tarikh: ...............................

FOR PARTICIPANTS UNDER THE AGE OF 18

UNTUK PESERTA DI BAWAH UMUR 18 TAHUN

I, parent/ guardian of the participant, whose particulars are above, confirm that I fully
understand and appreciate the effect of the above Waiver and hereby agree and declare
on behalf of the participant that the purpose of the Waiver Clause will have equal binding
effect on the participant. I hereby consent to his/ her participation in the ‘Be the Movement’
charity walk. / Saya, ibubapa/ penjaga kepada yang empunya butir-butir seperti tertera di atas,
mengesahkan bahawa saya faham sepenuhnya dan maklum akan kesan kepada perlepasan
yang tersebut di atas dan dengan ini bersetuju serta mengisytiharkan bagi pihak peserta
bahawa tujuan Klausa Perlepasan juga membawa kesan yang sama terhadap peserta.
Saya dengan ini bertanggungjawab terhadap penyertaan peserta ini di dalam jalan kaki amal
“Be the Movement”.

brought to you by

Signature / Tandatangan: .......................................

(Parent/ Guardian / Ibupaba/ Penjaga)
Date / Tarikh: ...............................
Event Details Charity Walk 5-km route

1. Date of Event : 30 October 2010, Saturday Charity Walk in support of World Hunger Relief 2010
2. Time : 5.00 pm onwards
Flag-off time : 8.15 pm
3. Venue : Istana Kehakiman, Presint 3, Putrajaya By the time you read this, a child will have died of hunger.
4. Distance : 5 km in all, with 3 km option One child dies of hunger every five seconds.

5. Achievement wristbands:
Organised by KFC and Pizza Hut Malaysia, Be The Movement
3 km finisher : Limited Edition YELLOW wristband
2010 is our opportunity to work towards eradicating hunger
5 km finisher : Limited Edition BLUE wristband all over the world. Now in its third year, our charity walk is
6. Registration Fee: RM20 (Cash only) being held in support of World Food Programme.
7. All participants will receive a free limited edition ‘Be The Movement’
T-shirt to be worn during the walk. T-shirt collection is done on Be The Movement 2010 charity walk will span a 5-km route that
begins and ends in front of the Istana Kehakiman in Putrajaya.
the day of the event at the collection booth from 5.00 pm - 7.00 pm.
Activities include a games carnival, a concert featuring Ramli
8. Registration can be done in:
Sarip, fancy dress competition, colouring contest for the kids
• KFC & Pizza Hut, Alamanda, Putrajaya (10.00 am - 8.00 pm) and other exciting programmes.
• KFC, Cyberjaya (10.00 am - 8.00 pm)
• F.T.A.A.A. Office, 2nd Floor, Wisma OCM It takes only RM1.00 to fill 1 cup of rice – enough to feed a child
Jalan Hang Jebat, 50150 Kuala Lumpur for one day. Do your part to eradicate hunger.
10.00 am – 6.00 pm (Monday to Friday)
Hurry, as registration ends 22 October 2010!
9.30 am – 2.00 pm (Saturday)
• www.hooha.asia
9. Enquiries:
a) For enquiries pertaining to ‘Be The Movement’, please contact:
Telephone : +603 5637 3821
Email : enquiry@twentyfirstcenturysports.com
b) Online registration and payment
For all enquiries pertaining to online registration and payment,
please email to: enquiry@hooha.asia
10. Registration closes on 22nd October 2010 (6.00 pm) ’
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