Registration | AFM Wheel Power

Registration Form

Select ONE Category Only

Category 1 - Individual (25km Route)

Category 2 - Individual Kids (6km Route)

Category 3 - Team (4 per Team, 6km Route)

Entry: RM100 Donation*

Entry: RM50 Donation*

Entry: RM200 Donation*

*LHDN Tax Exemption Receipt provided

Main Participant Contact Information

Main Participant Full Name (as per NRIC/Passport)

(For Teams, an e-form will be emailed for remaining 3 Members' submission)

Main Participant NRIC/ Passport

(For Teams, an e-form will be emailed for remaining 3 Members' submission)

(For Kids - please state Guardian's Email)

Mobile Phone

(For Kids - please state Guardian's Number)

Guardian Name

(For Kids Participant Only)

Receipt Name - Please State Income Tax Exemption Receipt Recipient

(Full Name as per NRIC / Full Company Name)

With this submission I confirm that all information submitted is true and accurate, and indemnify the Arthritis Foundation Malaysia (AFM), its Organisers and Partners from all mishaps that may occur from this participation.

I am interested to Sponsor/Partner with AFM Wheel Power. Please contact me for a discussion (contact details above).

Payment Instructions

Please transfer payment to Arthritis Foundation Malaysia with your Mobile Number in the Reference Column.

Bank: Maybank Bhd
Account: 5140-1114-4237

Upload Payment Receipt

Thanks for submitting!

Registration Form

*LHDN Tax Exemption Receipt provided

Main Participant Contact Information

(For Teams, an e-form will be emailed for remaining 3 Members' submission)

(For Teams, an e-form will be emailed for remaining 3 Members' submission)

(For Kids - please state Guardian's Email)

(For Kids - please state Guardian's Number)

(For Kids Participant Only)

(Full Name as per NRIC / Full Company Name)

Payment Instructions

Please transfer payment to Arthritis Foundation Malaysia with your Mobile Number in the Reference Column. Bank: Maybank Bhd Account: 5140-1114-4237

Please transfer payment to Arthritis Foundation Malaysia with your Mobile Number in the Reference Column.

Bank: Maybank Bhd
Account: 5140-1114-4237