KLBA /Titijaya Cup 17 & Under Basketball Championship 2023

2023年吉隆坡篮总/ Titijaya杯十七岁或以下篮球锦标赛

Team Name: Jersey Colour: White & (Dark):

Category: Boys Girls

* Please mark X
* Please write the jerseys numbers in ascending order (ie 00, 0 - 99)

Jersey Date of Birth Height Weight T-Shirt

No Family Name Given Name 中文名字 (dd/mm/yy) MyKad No Position

(cm) (kg) Size

Example Chen Beng Ho 曾文何 05/12/05 051205-14-1234 190 63 C XXL

Example: 01x - xxx xxxx

Shirt
16 Team Manager: 姓名: Mobile No: Size
Shirt
17 Head Coach: 姓名: Mobile No: Size
Shirt
18 Assistant Coach: 姓名: Mobile No: Size
Shirt
19 Team Official: 姓名: Mobile No: Size

DATELINE: 14th August 2023 (Monday) 8pm

I, the undersigned, hereby certify that our team will participate in the tournament and abide by all the rules and
regulations of the tournament, as well as adhere to all SOPs provided by the relevant authorities

Team Manager / Coach Name: Signature: Date:

 KLBA /Titijaya Cup 17 & Under Basketball Championship 2023

2023年吉隆坡篮总/ Titijaya杯十七岁或以下篮球锦标

Team Name: Jersey Colour: White & (Dark):

Category: Boys Girls

Photo Photo Photo Photo

Jersey No
Name
中文名字

Photo Photo Photo Photo

Jersey No
Name
中文名字

Photo Photo Photo Photo

Jersey No
Name
中文名字

30/12/99
Team Manager / Coach Name: Signature: Date: