TARCIAN RUN

Registration Form

Personal Information

Your personal details. Note to only use 1 email per registration

Full Name*

ID Type *

NRIC *

Nationality *

Student ID/Staff ID No.

Branch *

Date of Birth *

Gender *

Email Address *

Full Address*

Mobile No. *

Emergency Contact Person

Person we can contact in case of emergency

Name *

Relationship*

Contact No.*

Medical History Questions

Few questions regarding your medical history

Prolonged medical treatment and/or repeated hospital admissions for any reason, including a major operation or psychiatric illness *

Yes

Heart condition including coronary disease, hypertension, valve or congenital disease*

Yes

Are you taking any presribed pills or medication?*

Yes

Additional Notes

Choose only one category *

Categories *

Fun Run (Student/Staff)

Fun Run (Alumni/Family Members)

T-Shirt Size *

Waiver Clause

Waiver clause

In consideration of the organizer accepting this entry, and registration to participate in the above Run, I hereby waive and release any and all rights or claims to damages. I may have against the organizers holding this Run, their agents, representatives, successors, assigns, reace sponsors for any and all injuries, death and invalidity I may have sustain before, during or after the course of the event or arising as a result of it. I hereby indemnify the organizers and keep them indemnified and waived against all claims or damages that arise in consequence of the above. I hereby declare that the information provided is true and correct. *

I agree to the terms.

Need help? Contact TARCian Alumni Association at WhatsApp +6012-294 0128 or taamyhelpdesk@gmail.com