0) { $reg_id = $_POST["reg_id"]; $reg_query = mysql_query("SELECT * FROM js_registration_tmp WHERE reg_id = '$reg_id'"); $reg_row = mysql_fetch_array($reg_query); $reg_name = $reg_row["reg_name"]; $reg_email = $reg_row["reg_email"]; $reg_age = $reg_row["reg_age"]; $reg_dob = $reg_row["reg_dob"]; $reg_gender = $reg_row["reg_gender"]; $reg_ic = $reg_row["reg_ic"]; $reg_add = $reg_row["reg_add"]; $reg_postcode = $reg_row["reg_postcode"]; $reg_contact = $reg_row["reg_contact"]; $reg_size = $reg_row["reg_size"]; $reg_category = $reg_row["reg_category"]; $reg_survivor = $reg_row["reg_survivor"]; $reg_ename = $reg_row["reg_ename"]; $reg_econtact = $reg_row["reg_econtact"]; $reg_erelation = $reg_row["reg_erelation"]; $reg_dob = str_replace("-", "/", date("d-m-Y", strtotime($reg_dob))); } ?>


  • Registration
  • Payment
  • Completed
Please fill all the information.
Name (as per I.C.) :
E-Mail :
Age :
Date Of Birth (dd/mm/yyyy) :
Gender :
I.C. / Passport Number :
Address :
Postcode :
Contact Number :
Cancer Survivor :
Category :
T-shirt Size :

sizes subject to availability on first-come-first-served basis

Emergency Contact

Name :
Contact Number :
Relationship :

WAIVER: I understand cross country running or walking activities present inherent risks, including but not limited to exposure to adverse weather conditions, sprains, broken bones, cuts, and bruises.

I fully understand the risks and scope of the activities involved in this event, and agree to assume the risk of my participation and/or minor child(ren)’s participation in the event, including the risk of catastrophic injury or death. I hereby release and fully discharge Pink Ribbon Wellness (L) Foundation, its trustees, officers, employees and agents, and all event sponsors, workers, officials and volunteers from all liabilities in connection with my participation and/or my child(ren)’s participation in this event, of or on account of my injury to or illness of my person or death, or for or on account of any loss of damage to any personal property or effects owned by me and/or my child(ren).

I agree to abide by all rules of participation.

I understand that Pink Ribbon Wellness (L) Foundation does not require a medical examination or screening prior to my participation in the event and that it is my responsibility to ascertain whether I am sufficiently physically fit to do so.

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