EmailMe Form - Formulir Pendaftaran KEJURNAS LAYAR

Formulir Pendaftaran KEJURNAS LAYAR

Kejuaraan Nasional Layar 2022

Nama Lengkap *
Nama Sesuai Akta Lahir
Tanggal Lahir *
DD / MM / YYYY
Email
Phone/HP
Pengprov/Club *
Class *
Techno 293 Girls
Techno 293 Boys
Exhibition - Techno 293 Plus Women
Exhibition - Techno 293 Plus Men
Exhibition - IQ Foil Women
Exhibition - IQ Foil Men
Exhibition - Formula Kite
Optimist Girls
Optimist Boys
ILCA 4 Girls
ILCA 4 Boys
ILCA 6 Women
ILCA 6 Men
ILCA 7 Men
Int. 420 Girls
Int. 420 Boys
Int. 470 Mixed
Hobie 16 Open
Sail Number
Sailor Position As *
Skipper
Crew
Lampirkan
Akta Lahir *
Ukuran File Maks 500 KB
Selain nomor Optimist, Techno 293, ILCA 4, ILCA 6 Men dan Int. 420 dapat menggunakan ID lain.
Lampirkan
Kartu Keluarga (KK)/KTP *
Ukuran File Maks 500 KB
Image Verification

Please enter the text from the image:
[Refresh Image] [What's This?]

Powered by

EMF Contact Form