______________________________________________________________

To whom it may concern,

I, the undersigned,
Name : _______________________________________
ID number : _______________________________________
(KTP/KTM/SIM/PASSPORT/KITAS)

hereby giving the authorization to:

Name : _______________________________________
ID number : _______________________________________
(KTP/KTM/SIM/PASSPORT/KITAS/KIMS) to collect my Race Pack on my behalf.
Along with this letter are the required documents for the Race Pack Collection:
Printed confirmation document Photocopy of ID
(KTP/KTM/SIM/PASSPORT/KITAS) Before collecting the race pack, my
representation will present a photo identification for verification purposes. I
understand that the absence of any of the items mentioned above, the event
committee has the right to decline my race pack collection under any
circumstances. With this I declare this Authorization Letter, along with the
supporting documents are confirmed and true.

Regards, ___________________________ _____________

[Participant’s signature] [Date]

 Authorization Letters available only for 13K and 25K race category
 Put the waiver, medical certificate, copy ID in this form together