聯絡我們
挑戰組別 Category
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休閒組 Casual (4km)
活力組 Vitality (7km)
挑戰組 Challenge (11km)
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英文姓名 English Name
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僅英文字母 Only alphabet
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中文姓名 Chinese Name
性別 Gender
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男 Male
女 Female
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年齡 Age
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國籍 Nationality
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Malaysia
Brunei
China
Indonesia
Japan
Korea
Philippines
Singapore
Taiwan
Thailand
Others
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身份證 / 護照號碼 IC/ Passport No.
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聯絡號碼 Contact No.
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電子信箱 Email
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緊急聯絡姓名 Emergency Contact Name
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緊急聯絡電話 Emergency Contact Number
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在籍教師/學生所就讀學校 School Attended Currently
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不相關 Not Applicable
幼兒園 Kindergarten
小學 Primary Schools
中學 Secondary Schools
私立/國際學府/大專院校 Private/ International Institution /Colleges and Universities
身份別 Identity
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佛光會員 BLIA Members
佛光人 Fo Guang Members
教職人員 Educator
民眾 Public
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衣服尺寸 T-shirt Size
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衣服尺寸提交後不得更換。 T-shirt size cannot be exchanged after submission.
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Children-S
Children-M
Children-L
Children-XL
Adult-S
Adult-M
Adult-L
Adult-XL
Adult-XXL
Adult-XXXL
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結緣品領取日期 Souvenir Collection Date
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03.05.2025 (六 Sat)
24.05.2025 (六 Sat)
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健康狀況 Health Status
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良好 Good
特殊疾病 Illness
食品過敏 Food Allergy
藥物過敏 Medical Allergy
其他 Others
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備注 Remarks
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疫苗接種狀態 Vaccination Status
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未接種疫苗 Not Vaccinated
完成第一劑 First Dose Completed
完成第二劑 Second Dose Completed
已完成接種 Fully Vaccinated
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本人,
, 身份證/護照號碼
, 報名參加國際佛光會南馬協會主辦之2025年全球復蔬公益路跑。
I,
, IC/ Passport No.
, signed up for the 2025 Global Veggie-Revival Community VegRun", organized by BLIA Malaysia South Chapter.
本人了解參與2025年全球復蔬公益路跑可能產生突發性風險和危害並願意承擔一切相關風險和延誤。當情況發生時，本人授權於主辦單位讓正式註冊之醫護人員為本人進行必要的緊急醫療服務。若因參與活動對本人造成任何傷害和損失﹐在被法律所允許的最大程度上，本人同意放棄向主辦單位追究任何法律上的責任和賠償。本人也願意承擔所有一切的醫療費用。
本人知悉並同意所提供的個人資料僅用於活動的組織與管理，並將依據個人資料保護法 (PDPA) 進行處理。
I understand that participation in the 2025 Global Veggie-Revival Community VegRun may involve unexpected risks and hazards. I am willing to accept all risks and delays associated with this event. In the event of such a situation, I hereby authorise the organizer to provide emergency medical assistance to me by registered medical personnel. I agree to waive any legal liabilities and compensations to the maximum extent permitted by law for any injury or damage caused to the applicant. I also agree to bear all medical expenses.
I acknowledge and consent that the personal data provided will be used solely for the purpose of organizing and managing the event, in accordance with the Personal Data Protection Act (PDPA).
我同意 I agreed
