reopen2 Please enable JavaScript in your browser to complete this form.123Please prepare your ID Card to fill this form Registration will be closed on January 14, 2024 Race Type *FRIENDSHIPRUN10KFRIENDSHIPRUN17KPERSONAL INFORMATION Take your time to fill in this registration form as accurate as possible.LayoutEmail *Same email can only be used for one runnerFirst Name *Last Name *Date of Birth *Phone Number *Please include country code and area code (if required)Blood Type *ABABOGender *MaleFemaleFile Upload * Click or drag a file to this area to upload. Upload your Passport/KTP gif|jpg|png|jpeg|pdf (max filesize 5Mb)Payment Instruction Please make a payment immediately before January 14, 2024. Bank Transfer Information : Bank Mandiri PT. ARTA PURNAMA INDONESIA 1850080889998 Payment Nominal : IDR 150.000Payment Upload * Click or drag a file to this area to upload. Upload your Payment Proof in format gif|jpg|png|jpeg|pdf (max filesize 5Mb)Next T-Shirt Size *– Please Select –3XS2XSXSSMLXL2XL3XL4XL5XL6XLNextIn case of emergency, who should we contact?LayoutEmergency Contact Name *Emergency Contact Number *Please include country code and area code (if applicable)Submit
