PORT DICKSON TRIATHLON 2026 - Individual Registration

Name *

IC / Passport *

Phone *

Gender *

Email *

Date of Birth *

Address *

City *

Postcode *

State *

Country *

Nationality *

Event Category *

Junior Category *

OD Category *

T-Shirt Size *

Emergency Contact Person *

Emergency Contact Number *

Relationship *

Medical Condition/Allergies (if any)

Insurance Protection *

‘I have read the privacy policy (below) and giving my consent to appointed Insurance Company to collect my personal data for coverage of group personal accident insurance for PORT DICKSON TRIATHLON 2026.’

'Privacy Policy : By providing your personal information, you are deemed to have given consent and authorisation to the appointed Insurance Company to collect your personal information supplied to insurance company for the purpose of contacting you by all modes of communication including telephone calls, SMS or emails in order to respond to your enquiry in relation to the event only.'

Terms & Conditions *

‘I have read and agree to abide by the Event Rules and Regulations of PORT DICKSON TRIATHLON 2026.'

‘I have read and accept the Event Waiver of PORT DICKSON TRIATHLON 2026.'

Promo Code

Amount

RM

Discount Amount

RM

Gross Amount

RM

Payment Method

Ipay88 Online Payment Gateway

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*

Individual Registration

Personal Details

Emergency Contact

Payment Information