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PARI SAKTI DIVING INTERNATIONAL COMPETITION

GBK Aqua c Stadium Senayan, Jakarta, Indonesia


16 – 18 May 2024

PRELIMINARY ENTRY FORM


( Please return by 15th March 2023 to : parisak dv.organizer@gmail.com )

1 Team Name : Be er Diving Club


2 Contact Person : Muharam Saribi
3 Phone Number : 082113096242
4 Email : be erdivingindonesia@gmail.com

Yes, we will par cipate in PARI SAKTI DIVING INTERNATIONAL COMPETITION

MALE FEMALE TOTAL


1 Number of Divers : 3 3 6
Number of Officials :
2 3 3
& Judge

Submi ed by
Name : Muharam Saribi
Designa on :

Signature :

Date (dd/mm/yyyy) : 15/03/2024

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- Preliminary Entry Form –

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