Perhentian_Marathon_Application_form

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main
PD 10km Marathon
Clinic/Training Schedule
clinic/Training Registration
Perhentian Island
Sponsors
Shop
Results & Album
Swimmers Ranking
About us

APPLICATION FORM FOR PARTICIPATING IN 16KM PERHENTIAN ISLAND MARATHON SWIM - 5th Oct 2019

Note: This event is limited to 30 slots solo and 20 slots for Duo/Team. Your application will be reviewed and the result will be sent to you within 4 weeks after submission. You will be offered a slot if your application is successful.

Name ( as per IC/Passport no)

Event choice

Solo 16km

Duo 16km (team of 2)

Team 16km (team of 4)

if Relay:

all males

all females

mix gender

if solo:

Male

Female

contact no

Email Address

Nationality

Current country you reside

Solo: Your OWS experiences for the past 24 months in the event of 10KM or longer distance

Never

once

twice

thrice or more

solo:Please specify the event name you participated, 10km or above.

solo: Your current average speed per kilometer

10min - 20min

21min - 40min

41min -60min

more than 60min

Your /(team) target to complete 16km swim

between 3-4 hours

between 4-5 hours

between 5-6 hours

between 6-7 hours

Do you have any medical condition?

None

Asthma

Diabetes

Heart

Epilepsy

Other

If other, please eloborate

Could you describe why we should qualify and approve your application. If relay; please describe each of member ows experiences. note: cut-off time is 7 hr 30 min

if you have sport CV or Profile - please email to us via info@malaysiaopenwaterswimming.com

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Note: Please fill out the fields marked with an asterisk.