邁向金禧年
永中百萬元教育基金籌募
系列1之“永中行”義跑
ORGANISED BY: YONG PENG HIGH SCHOOL & YONG PENG HASH HOUSE HARRIERS
OBJECTIVE: TO RAISE FUNDS FOR YONG PENG HIGH SCHOOL
DATE: SUNDAY, 30TH APRIL 2006
TIME: 8:00AM
VENUE: PUBLIC FIELD,JALAN TEMPLER YONG PENG
CLOSING DATE :30TH APRIL 2006 (8:00AM)
AWARDS: CHAMPION, 1ST RUNNER UP, 2ND RUNNER UP, 3RD RUNNER UP &
4TH TO 14TH PLACES － TROPHY
ENQUIRES / ENTRY FORM / PAYMENT SHOULD BE SUMMITTED TO:
YONG PENG HIGH SCHOOL
JALAN SEKOLAH CHNA,YONG PENG
MR. PHUA YOKE NAU H/P:019-7756555(YPH3)
MR. LING HWA SENG H/P:013-7275363(JUNIOR)
FULL NAME:
ADDRESS:_____________________________________________________________
DATE OF BIRTH:________________________
AGE ON 30.4.06:____________________
ENTRY FEE: OPEN&VETERAN-RM30
HIGH SCHOOL-RM15
PRIMARY SCHOOL-RM10.
PLEASE TICK (√) FOR CATEGROY AND T-SHIRT SIZE:
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MALE |
FEMALE |
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M |
L |
XL |
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OPEN (UDER 45YEARS) |
6KM |
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VETERAN (45YEARS&ABOVE) |
6KM |
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HIGH SCHOOL (SENIOR) |
4KM |
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HIGH SCHOOL (MIDDLE) |
4KM |
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PRIMARY SCHOOL (JUNIOR) |
3KM |
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WAIVER CLAUSE:
I, the above-name, hereby submit my entry and agree to abide by the rules and
regulations of the race. I certify that the particulars stated are correct and I am
physically trained to participate in the“永中行” Charity Run 2006. I also certify
that the organizers and sponsors shall not be held in any way responsible for any
accidents, injuries, deaths, loss of property before, during and after the competition.
SI GNATURE:
PARTICIPANT PARENT / GUARDIAN
(PARTICIPANT BELOW AGE 18)
DA TEL:
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