BALLOON WALK 3KM REGISTRATION FORM
 
Category * OKU Card No
Full Name * NRIC / Passport No *
Gender * Date Of Birth *
Address * Contact No *
Postcode * T-Shirt Size *
City * Emergency
Contact Name
Email Address * Emergency
Contact No
       
Payment can be made by bank-in transfer to :
WQ Medic Sdn Bhd
Ambank cc no (128-202-200387-5)
and email the receipt of payment to carnival@wqpark.com.my or whatsapp to +6019 308 4899
       
       
T-Shirt Measurement
SIZE 2XS XS S M L XL 2XL 3XL
CHEST 34'' 36'' 38'' 40'' 42'' 44'' 46'' 48''
LENGTH 24'' 25'' 26'' 27'' 28'' 29'' 30'' 31''
       
       
LIABILITY WAIVER AND BALLOON WALK AGREEMENT:
I have considered the nature and extent of the risks involved in my participation in Balloon Walk, and I voluntarily choose to assume all such risks, both known and unknown, even those risks that result from the negligence of event organizer, sponsors, volunteer and all parties involved in Balloon Walk and I assume full responsibility for my participation during the event.

I acknowledge and accept that circumstances concerning the event may change from time to time for reasons out of the event organizer’s reasonable control.

I also confirm I will not be under the influence of any drugs, alcohol or any illegal substances while participating in the walk.

I hereby discharge event organizer and all other sponsoring companies or agencies or individuals involved in Balloon Walk from any and all claims or responsibilities for damages for personal or bodily injury, disability, death loss of my belongings, and loss or damage to person or property relating in any way to the event.

I consent to receive medical treatment which may be deemed advisable during the event. Additionally, I permit the use of my name comments, feedback, ideas, videos, recordings and pictures without notice for newspapers, brochures, websites and any other medium of this event.
       
 Agree
 
 
 
     
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