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WELCOME TO RFC 2024 REGISTRATION CENTER
Please fill in the registration form for MEDIA PERSONNEL
RFC 2024 MEDIA PERSONNEL REGISTRATION FORM
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Step
1
of 2
PERSONAL DETAILS
First Name
*
I.C / Passport Number
*
Attached I.C or Passport Image
*
Please upload your I.C or Passport indicating your photo and name for verification.
Citizenship
*
Kindly state the country of citizenship
Email Address
*
Media Agency Name
*
Please enter the name of the media agency that you represent
Company URL
*
T-Shirt Size
*
S - Height (66cm) x Width (46cm)
M - Height (67cm) x Width (48cm)
L - Height (69cm) x Width (51cm)
XL - Height (71cm) x Width (53cm)
XXL - Height (75cm) x Width (57cm)
XXXL - Height (77cm) x Width (59cm)
Event T-shirt Size
Last Name
*
Date of Birth
*
dd/mm/yyyy
Mobile Phone
*
Please include Country code
Emergency Contact Name
*
Person to contact in case of an emergency
Emergency Contact Number
*
Emergency contact number
First Aid Course
*
Yes
No
Please indicate if you have any first aid course training.
Blood Type
*
A negative
A positive
B negative
B positive
O negative
O positive
AB negative
AB positive
Pre-existing Illnesses
Please declare any pre-existing illnesses which you may have.
INDEMNITY
*
I hereby agree to abide by the Rules & Regulations and instructions of the Organiser of the Rainforest Challenge 2024. I understand that I am participating in this event on my own accord and will not hold the organisers, creator/founder, sponsors, officials, marshalls, servants, representatives or anyone appointed by the organiser responsible for any mishaps, death, loss, injury or damage to my property, vehicle and personal belongings for the duration of the event. Failure to comply with any instructions from the event organiser may result in immediate dismissal from the event.
VERIFICATION OF IDENTITY
*
Kindly bring along your Identity document for verification when you arrive at the location for collection of your ID Badge and T-shirt
AUTHORIZATION
*
I hereby agree to authorize Offroad & Xpedition Sdn. Bhd. to make payment to the below stated bank account and hereby certify that all information and details given above is correct and accurate.
Bank Name
*
Bank Account Number
*
Name as per bank account number
*
Bank Branch
Country
*
Please enter the name of the country where your bank account belongs to
Bank SWIFT code or IBAN
THE ORGANISER RESERVES THE RIGHT TO REFUSE ANY ENTRY WITHOUT FURNISHING ANY REASON WHATSOEVER FOR ITS REFUSAL
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INDEMNITY Mobile Company
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