“为爱而跑”义跑筹募活动 - 报名表
Charity Run Registration Form

【Information 资讯】

Organizer 主办单位:
Church of Holy Name of Mary Charity Run Committee
圣母圣名堂为爱而跑筹委会

Aim 宗旨:
1. 为提倡筹款于圣安纳洗肾中心及圣母圣名堂仁爱基金
To raise the fund for St.Anne Haemodialysis Centre and Welfare
Fund for Parish Church of Holy Name of Mary.

Date 日期:
23-08-2014 ( Saturday )

Time 时间:
6.00 A.M – 12.00 P.M

Venue 地点:
Church of Holy Name of Mary, Permatang Tinngi
峇冬丁宜圣母圣名堂

Registration Fees 报名费:
RM20.00
(Goodies Bag are limited to first 1000 participant)

Distance 路程:
10 KM

Participation 参加资格:
Open to Malaysian 大马公民

Closing Date 截止日期:
27-07-2014

Enquiries 询问:
Nigel Lai 赖君国 017-428 6620

Register 报名 :
Mary Anne 011-1655 8153
Celine Yee 余莹莹 016-494 8776
Teh Lisa 郑丽莎 017-593 9763
Holy name of Mary parish office
圣堂办公室 04-5887799
  • Please write in English
    请写出英文名,必须和身份证上的名字一样
  • / /
  • Waiver Clause

    I, the participant, hereby agree to abide by the rule and conditions of the Run Event. I certify all of the above particulars are correct. I am entering the Run Event at my own risk shall not hold the organizer responsible for any accident/injury/death/loss of property, however caused before, during or after the Run Event.



  • Authorization by parent / guardian of participants under 18 years
    18岁以下家长/监护人同意书

  • Please write in English
    请写出英文名,必须和身份证上的名字一样
  • 凡是18岁以下的参加者,如果没有给足以上这资料将不被接受报名。
    For participant under 18 years, we din't allow to register if din't fulfill the information above.
  • Remittances 汇款方式

    银行 Bank :
    Public Bank 大众银行
    Account Name : Boo Rui Xiu
    Account Number : 3-1879442-13

    *汇款后请拍下Receipt或Scan或Print screen,然后上传。
    Please attach the file [Scan the receipt/snap photo/print screen(for transfer)] after remittance.
Powered byEMF HTML Contact Form
Report Abuse