7/21/22, 5:19 PM [IJ] Registration Form Petrosains RBTX Challenge 2022

[IJ] Registration Form Petrosains RBTX

Challenge 2022
Innovation Junior Category / Kategori Innovation Junior

Section 1: Group Participation Details (1/4)

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Group Name / Nama Kumpulan

Lok Heng Selatan A

Participant's Name 1 / Nama peserta 1  *

as per Identity Card / seperti kad pengenalan

MUHAMMAD AMIZI BIN ZAMRI

Age / Umur *

11

Identity Card No. / No. Kad Pengenalan *

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eg. 900101100101

110724011205

Email address / Alamat emel *

huszarudin@gmail.com

Mobile number / Nombor telefon *

eg. 60323317240

137144438

Section 1: Group Participation Details (2/4)

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Participant's Name 2 / Nama peserta 2 

as per Identity Card / seperti kad pengenalan

MUHAMMAD FAHIM AMSYAR BIN MOHD FAIZAL

Age / Umur

11

Identity Card No. / No. Kad Pengenalan

eg. 900101100101

110202010627

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Email address / Alamat emel

huszarudin@gmail.com

11

Mobile number / Nombor telefon

eg. 60323317240

137144438

Section 1: Group Participation Details (3/4)

12

Participant's Name 3 / Nama peserta 3 

as per Identity Card / seperti kad pengenalan

MUHAMMAD FARISH HAIKAL BIN ABDULLAH

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Age / Umur

11

14

Identity Card No. / No. Kad Pengenalan

eg. 900101100101

110120010869

15

Email address / Alamat emel

huszarudin@gmail.com

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Mobile number / Nombor telefon

eg. 60323317240

137144438

Section 1: Group Participation Details (4/4)

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Participant's Name 4 / Nama peserta 4

as per Identity Card / seperti kad pengenalan

MUHAMMAD FARISH HAKIMIE BIN ISMAIL

18

Age / Umur

11

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Identity Card No. / No. Kad Pengenalan

eg. 900101100101

110125011449

20

Email address / Alamat emel

huszarudin@gmail.com

21

Mobile number / Nombor telefon

eg. 60323317240

137144438

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Section 2: School or Organization Details

22

Teacher's  Name / Nama Guru  *

as per Identity Card / seperti kad pengenalan

Huszarudin Bin Hussin

23

Identity Card No. / No. Kad Pengenalan *

eg: 900110100101

851211015305

24

Mobile number / Nombor telefon *

eg. 60323317240

78948089

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Email address / Alamat emel *

huszarudin@gmail.com

26

Name of school or organization / Nama sekolah atau organisasi *

SK Felda Lok Heng Selatan

27

School or organization address / Alamat sekolah atau organisasi *

SK Felda Lok Heng Selatan, 81900 Kota Tinggi, Johor

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State / Negeri *

Johor 

Section 3: Personal Data Protection Act (PDPA)

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Condition of use

By submitting your personal details, you are allowing PETROSAINS to use your personal data
for the purpose of your participation in Petrosains RBTX Challenge 2022 and for PETROSAINS’
promotional activities and anything related to it.

The personal data collected shall be kept safely at PETROSAINS and the data will be retained
for a reasonable period or for as long as the law requires, after which PETROSAINS shall
destroy all personal data submitted by you, together with any other related documents
submitted thereto.

PETROSAINS will not disclose any of your personal data collected herewith to any third party
except where you have given PETROSAINS permission to do so or when PETROSAINS is
required and/or allowed to do so by law.

The accuracy of the personal information depends to a large extent on the information you
provide. Therefore, kindly update PETROSAINS as and when your personal information
provided earlier becomes incorrect or out of date.

If at any time, you wish to withdraw such consent you have given for the usage of your
personal data, you may contact Petrosains RBTX Challenge 2022 Secretariat to do so.

*Petrosains Sdn. Bhd. will not be liable for any claims, losses, including property damage,
personal injury, accident and/or loss of life arising out of or in connection with this
competition.

*
Syarat Penggunaan

Dengan memberikan maklumat peribadi anda, anda membenarkan PETROSAINS untuk menggunakan data
peribadi anda untuk tujuan penyertaan anda ke Petrosains RBTX Challenge 2022 dan untuk aktiviti promosi
PETROSAINS yang berkaitan dengannya.

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Data peribadi yang dikumpul akan disimpan dengan selamat di PETROSAINS untuk tempoh yang munasabah atau
selagi undang-undang membenarkannya, selepas itu PETROSAINS akan memusnahkan semua data peribadi yang
telah diberi oleh anda, bersama-sama dengan dokumen lain yang berkaitan.

PETROSAINS tidak akan mendedahkan sebarang data peribadi anda kepada pihak ketiga kecuali jika anda telah
memberi kebenaran kepada PETROSAINS untuk berbuat demikian atau apabila PETROSAINS diperlukan dan/atau
dibenarkan untuk berbuat demikian oleh undang-undang.

Ketepatan data peribadi bergantung kepada maklumat yang anda berikan. Oleh itu, sila kemaskini maklumat
peribadi anda dengan PETROSAINS jika maklumat peribadi yang diberikan lebih awal sudah berubah.

Bila-bila masa, jika anda ingin menarik balik kebenaran menggunakan data peribadi anda, anda boleh
menghubungi mana-mana Sekretariat Petrosains RBTX Challenge 2022, untuk berbuat demikian.

*Petrosains Sdn. Bhd. tidak akan bertanggungjawab ke atas sebarang tuntutan, kerugian, termasuk kerosakan harta
benda, kecederaan tubuh badan, kemalangan dan/atau kehilangan nyawa yang berbangkit daripada atau yang
berkaitan dengan pertandingan ini.

Yes, I agree / Ya, saya bersetuju

30

All information provided are correct / Semua maklumat yang diberikan adalah benar *

Yes, I agree / Ya, saya bersetuju

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