Illumi Fest Run Malaysia 2019 presented by MPI Generali Insurans Berhad: Registration 28/02/2019, 7*35 AM

CONFIRMATION SLIP

Participant's Particular Registration Details

Fullname
MOHAMAD ADLI ABDULLAH Date : 12 Nov 2018 10:35am
Registration ID : 5BE8E70C3FBAB
NRIC / Passport Number
920104035323 Registration Type : Public
Printed on : 28 Feb 2019 07:35am
Gender
MALE

Mobile number Category : Public - Individual (Super Early Bird)

+60-193612616
Apparel Size : XS - Unisex
Email
leeburgers92@gmail.com
Registration Fee : MYR 55.00
Date of Birth
04 Jan 1992 Donation : MYR 10.00
Invoice No. : CR5BE8E7C5A9331
Transaction No. : FIC00CR5BE8E7C5A9331
Payment Method : Online - Eghl

AMOUNT PAID : MYR 65.00

Letter of Authorisation

I hereby authorise ______________________________________________________(Fullname), ______________________

(NRIC / Passport Number), to collect the race entry pack on my behalf.

Accompanied with this letter, is a photocopy of my NRIC / Passport Number.

I acknowledge that in the event of an absence of the mandatory item as stated above, the Organiser reserves the right to
refuse collection of the race pack.

I hereby declare that this Letter of Authorisation, along with the supporting document, has been confirmed as being authentic.

Participant Particulars

Signature : ___________________________
Fullname : MOHAMAD ADLI ABDULLAH
NRIC / Passport Number : 920104035323
Date Feb 28th 2019
: ___________________________

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Illumi Fest Run Malaysia 2019 presented by MPI Generali Insurans Berhad: Registration 28/02/2019, 7*35 AM

Illumi Fest Run Malaysia 2019 presented by MPI Generali Insurans Berhad

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