H2O 5K Run 2017 Registration is Closed!

We are happy to let you know there are

more than 700 runners who registered



Thank you for all the support and feedback on our team,we apologize for any mistakes.

For more information,please email us at Mdrunning2017@gmail.com or visit us :
Instagram : @H2O5KRUN
Line Official Account : @ctr5250x



SEE YOU ON 19TH MARCH 2017 RUNNERS!!!
 
What is your First Name? *

 
What is your Last Name? *

 
What is your Gender? *


 
When is your Birthday? *

 
What is your preferred tee-shirt Size? *

If you are not so sure with your size, you may choose the bigger one.

 
Please provide us your active mobile phone number *

Kindly provide us with the phone number that you use the most
 
Could you tell us your Instagram account or ID? *

Let us tag you and your friends on Instagram and make it more fun!
 
Are you a member of a community? *

Good news ! Every 10 people from your community will get 10% discount. If YES, please tell us your community name, if no please answer with "NO"
 
Are you a member of LION CLUB OR LEO CLUB? *

A member of Lion/Leo club only have to pay Rp.125.000, if YES please tell us your CLUB NAME and your DISTRICT, if no please answer with "NO"
 
Where did you hear about this event? *


 
Do you need any medical assitances or needs? *


 
Please be aware that we are not liable for any injuries or health issues while participating in this event at any circumtances. *

Professional medical team or assistances are provided during the event.
     
 
Please ensure that all the information provide above are correct and can be used for event registration purpose.

 
Now it is the last step!

Please make the payment via Bank Transfer for the completion.

Bank : BCA (Bank Central Asia)
Account No. : 1271.236.323
Account Holder : Jessica Xaveria Ilyas

Your registration will be reserved once you done with the payment and only payment or transfer to our official bank account will be accepted!
 
You will not receive any email notification until you complete the payment. Please send us the receipt by email to Mdrunning2017@gmail.com , with subject [Payment_NAME] or [Payment_NAME_Community Name]

After we confirm your payment, we will reserve your booking and send you the receipt and ticket for RPC (Race Pack Collection)
 
any REGISTRATION and PAYMENT between 3th MARCH - 9th MARCH 2017 will collect the Race Pack on 19th March 2017 BEFORE THE EVENT IS START.

We extend our registration period due to the excitement of H2O 5K RUN. Race Pack production takes some time, please understand we try our best to fulfill your expectation =)
 
THANK YOU for joining H2O 5k Run 2017!!

We can't wait to have you onboard our event!!
And by that, you are now part of us to help water efficiency on helping people in Kalibaru Cilincing North Jakarta to get more clean water.

Let's run together and celebrate International Water Day 2017!!

Thanks for completing this typeform
Now create your own — it's free, easy & beautiful
Create a <strong>typeform</strong>
Powered by Typeform