ONLINE REGISTRATION FORM: SERVICE PROVIDERS Your details are important to us. Among other things, they will be used for: application of various permit/permission from authorities such as PDRM, Perhutanan, Perhilitan, UPEM, CAAM etc; emergency situations; printing of access card/security bracelet and allocation of t-shirt; food and beverages allocation. Please co-operate by giving us full information required below: Maklumat anda adalah penting kepada kami. Antara kegunaan maklumat tersebut adalah untuk tujuan: permohonan pelbagai jenis permit/kebenaran daripada pihak berkuasa seperti Perhutanan, Perhilitan, UPEM, CAAM dan sebagainya; situasi kecemasan; percetakan kad akses/gelang keselamatan dan pembahagian T-shirt; pembahagian makanan dan minuman. Sila berikan kerjasama dengan memberi semua maklumat yang diperlukan seperti di bawah: Service Providers DetailsService Providers(Required)PLEASE CHOOSESENIOR RACE OFFICIALSSCRUTINEERSMARSHALSPHOTOGRAPHERSVIDEOGRAPHERSACTIONCAM ENDURO RIDERMEDICAL SERVICESSATELLITE TRACKING SERVICESRESCUE AND RECOVERY SERVICESCOMPETITORS ROUTE AUDITORRACE TIMING SERVICESEQUIPMENT PROVIDERSHOSPITALITY SERVICESMEDIAOTHERS SERVICE PROVIDERSCOMPETITORS ROUTE AUDITORRACE SIMULATION RIDERType Senior Race Officials(Required)PLEASE CHOOSEMAM STEWARDSRACE DIRECTORDEPUTY RACE DIRECTOROPERATIONS DIRECTORCLERK OF THE COURSESECRETARY OF THE MEETCHIEF STEWARDCHIEF SAFETY OFFICERCHIEF MARSHALDEPUTY CHIEF MARSHALCHIEF RESCUE OFFICERCHIEF MEDICAL OFFICERMEDICAL COMMANDERMEDICAL DIRECTORCHIEF TIMING OFFICERCHIEF OF COMMUNICATIONCHIEF SCRUTINEERCOMPETITORS' RELATION OFFICERCHIEF HOSPITALITY OFFICERCHIEF FINANCIAL OFFICERType Marshal (Jenis Marshal)(Required)PLEASE CHOOSESTAGE COMMANDERS (Komander Sektor)1 POST CHIEF (Ketua Pos/Checkpoint)2 DEPUTY POST CHIEF (Pembantu Ketua Pos)RACE TIMING MARSHALRADIO MARSHAL (Marshal Komunikasi Radio)3 ROUTE MARSHAL (Marshal Bergerak Bermotorsikal)4 MARSHAL POWIL (Marshal Kenderaan Pacuan 4 Roda)SPECTATOR MARSHAL (Marshal Keselamatan Penonton)Checkpoint No(Required)N/A1 D1 Bukit Sumpah/D2 Bukit Nisan2 D1 Simpang Bekut/D2 Pokok Wangi3 D1 Sungai Kubor/D2 Pos Gentheh4 D1 Sungai Babok/D2 Pos Piah5 D1 Sungai Carlsberg/D2 Pos Poi6 D1/D2 Sungai Temin7 D1/D2 Ladang Tinggal8 D1/D2 Jeram BadakType Medical Services(Required)PLEASE CHOOCEPARAMEDIC - MEDIC BASEPARAMEDIC - AMBULANCEPARAMEDIC - BIKE MEDIKPARAMEDIC - RAPID INTERVENTION MEDIC (ATC/SSV)TECHNICAL/DRIVERType Hospitality Services(Required)PLEASE CHOOCEREGISTRATIONPUBLIC & CUSTOMER RELATIONSLOGISTICSMERCHANDISE SALESWELFAREOther Service (please specify)(Required)Section APublication / Company Name(Required)Full Name(Required)MyKad No.(Required)Nationality(Required)Gender(Required)MALEFEMALEAge(Required)Phone No(Required)Email Address(Required)Address(Required)Postcode(Required)State(Required)Please ChooseJohorKedahKelantanMelakaNegeri SembilanPahangPerakPerlisPulau PinangSabahSarawakSelangorTerengganuWilayah Persekutuan Kuala LumpurWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaSection BEmergency Contact Number(Required)Emergency Contact Name(Required)Blood Group(Required)Requires specific medical attention(Required)Please SelectYESNOIf YES, please specify:Bank Name(Required)Bank Account Number(Required)Bank Account Name(Required)Section CVehicle Make(Required)Model(Required)T-Shirt Size(Required)Selfie Photo (Current)(Required)Max. file size: 5 MB.Consent(Required) Saya dengan ini mengaku dan mengesahkan bahawa semua maklumat di atas adalah benar. CAPTCHA
