ENTRY FORM

LABUAN FITNESS RUN 2017

TICK
CODE CATEGORY REGISTRATION DATE FEE
()
M MALE OPEN 20 DIS 2016 15 FEB 2017 (EARLY BIRD) RM 75.00
F FEMALE OPEN 16 FEB 2017 10 MAR 2017 (STANDARD) RM 85.00
T-SHIRT SIZE : S / M / L / XL / 2XL / 3XL
OPEN FOR LABUAN, SABAH, SARAWAK AND BRUNEI DARUSSALAM
ACTIVITY : 10 KM DATE : 25 MARCH 2017
VENUE : LABUAN INTERNATIONAL SEA SPORT COMPLEX
TIME : 5.30AM 1.00PM

*NAME
___________________________________________________________________
(AS IN IC /PASSPORT)

MALE AGE : ________________

SEX :
FEMALE *NATIONALITY : __________________________

*I.C NO / PASSPORT: _________________________ DATE OF BIRTH : ______________________

*ADDRESS : ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

*MOBILE NUMBER : __________________________

*EMERGENCY CONTACT : ________________________________________________________________

*ILLNESS : YES
NO
IF YES, STATE : ____________________________________________________
PAYMENT RECEIPT

*REFERENCE NUMBER :
_________________________________ *PAYMENT : ________________
*NAME
(AS IN IC / PASSPORT) __________________________________________________________________
NOTE : RECEIVED BY :
_________________________________ ________________
PAID BY : ___________________________________
DATE :
__________________________________
DECLARATION

I CORFIRM THAT MY PARTCULAR DETAILS ARE TRUE AND THE ORGANIZER RESERVES THE RIGHTS TO
REFUSE MY PARTICIPATION ON THE SAID EVENT IF FRAUDELENCE FOUND IN ANY OF THE
INFORMATION DETAILS. I ALSO ACKNOWLEDGE THAT IM FIT ENOUGH TO PARTICIPATE IN

LABUAN FITNESS RUN 2017. I UNDERSTAND THAT THE ORGANIZER WILL NOT BE

RESPONSIBLE IN ANY CAUSE OF ACCIDENT, INJURY, LOSS OF PROPERTY OR DEATH, BEFORE,

DURING AND AFTER THE EVENT IS HELD.

SIGNATURE : ________________________ DATE : ________________________

Bank Transfer (online registration) Contact number :

Banks Name : AmBANK ZIN JUNO : 014-9506469

Account name : SERUMPUN BUDAYA KINABALU SABAH DEE LAYUN : 012-8932811
Account number : 8881015311691 Email : deelayun.resources@gmail.com
Please attach the PAYMENT SLIP for online registration,
by email OR Whatsapp to :
0198809287 / 0128932811

RECEIVED BY, OFFICIAL STAMPAD

DEE LAYUN RESOURCES

LA0015722-P

DATE :________________________
RULES AND REGULATION

1. Participation in Labuan Fitness Run 10KM is only Open for 18 Years old and above.

2. No group entries will be accepted for the Open 10KM Run. Only individual applications will
be accepted for the Labuan fitness 10KM Run.

3. Before sending in your application, please check if you have completed the following
mandatory. Where any discrepancy is found in any of the mandatory mentioned below, your
application will not be accepted .

- Filled in details against all mandatory fields, prefixed with * in the application form.
- Attach a copy of your Identity Card / Passport.
- Enclose the requisite application fees (Refer to application fees chart)
- Sign in the completed form.

4. Request for participation cancellation, and thereby refund will not be entertained.

5. Running Kit Collection :

- All confirmed participants are required to collect their running kit(t-shirt, Bib Number)
schedule from 18 March 2017 to 19 March 2017 at Financial Park Complex starts from
9.00am until 9.00pm and the last date of collection is on 24 March 2017 at Labuan
International Sea Sport Complex starts from 8.00am until 10.30pm.
- No running kit will be posted to an individuals mailing address.
- Medal will be given at the finish line on the race day.
- It is mandatory for an Open 10KM Labuan Fitness Run participant to collect his/her running
kit personally from the organizer. In case of unavoidable circumstances, such as runner can
send his/her authorised representative to collect the running kit on his/her behalf. Please
note, a representative will not be allowed to collect running kit on behalf of more than ONE
participant.
- Outstation and overseas participants can collect their running kit on 24 March 2017 at
Labuan Fitness Run 2017 counter located at Labuan International Sea Sport Complex, starts
from 8.00am until 10.30.

6. No baggage storage will be provided to all participants. It is strongly recommended that you
do not leave your personal belongings. Organizer are not responsible for any loss of baggage
or the belongings therein.

7. Only those confirmed participants wearing the Labuan Fitness Run 2017 running number
bibs will be allowed on the route. Any person found wearing the incorrect bib or no bib will
be disqualified and removed by the course security.

8. Registered participants must wear his/her running number bib on the front of the running t-
shirt. Any mutilation, fold, alteration or damage to the bib will amount to disqualification of
the runner from the event.

9. Photographs taken of runners during the running kit collection and race day may be used for
the purpose of promoting the event / future event.