PENANG INDIAN BADMINTON ASSOCIATION (4597/2011)

PIBA’S

PENANG / KEDAH JUNIOR CLOSED BADMINTON CHAMPIONSHIP

2013

ENTRY FORM

Name ________________________________________________

Gender _____  Age ______Date of Birth ____________

Address___________________________________________________________________________

City______________________________State_________________________           

Phone number_________      Email Address __________________

Please tick if you are state or ex- state player (______________)

Payment can be made by cash or bank into Penang Indian Badminton Association's  Account (CIMB  Bank Account No. 07190001359052)

 Event Information (Please Tick √ )

1.BOY'S SINGLE U-10 (   )   2.BOY'S SINGLE U-12 (  )

3.BOY'S SINGLE U-14 (   )   4.BOY'S SINGLE U-16 (   )  5.GIRL'S SINGLE U-15 (   )

Participant’s Signature ____________________________

Entry Form  can be submitted through email or fax to the following  below:

Fax No. 04-3234881 /  Email address : pibassm@gmail.com /

blogspot : http://pibassm.blogspot.com

Tournament Entry will only be confirmed after payment is made.