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FORMULIR PENDAFTARAN PESERTA

MOBILE LEGEND TOURNAMENT

Saya yang bertanda tangan di bawah ini :

Nama :

Nama TIM :

Alamat :

No. Telp :

Dengan ini bersedia menjadi peserta "Mobile Legend Tournament"


dengan biaya pendaftaran sebesar Rp.200.000,- dan bersedia
menaati ketentuan dan aturan yang telah ditentukan panitia. Kami
telah memahami persyaratan yang telah ditetapkan dan bersedia
mematuhi semua peraturan, serta siap menerima sanksi dari panitia
penyelenggara dalam bentuk apapun jika terbukti melanggar.

Makassar,.........................2019

Materai Rp.6000
DAFTAR PEMAIN

Nama Team :......................................................

1. Nama :..................................................................
TTL :..................................................................
Alamat :.................................................................. Foto 3x4
Pekerjaan :..................................................................
No. Telp :..................................................................

2. Nama :..................................................................
TTL :..................................................................
Alamat :.................................................................. Foto 3x4
Pekerjaan :..................................................................
No. Telp :..................................................................

3. Nama :..................................................................
TTL :..................................................................
Alamat :.................................................................. Foto 3x4
Pekerjaan :..................................................................
No. Telp :..................................................................

4. Nama :..................................................................
TTL :..................................................................
Alamat :.................................................................. Foto 3x4
Pekerjaan :..................................................................
No. Telp :..................................................................

5. Nama :..................................................................
TTL :..................................................................
Alamat :.................................................................. Foto 3x4
Pekerjaan :..................................................................
No. Telp :..................................................................

6. Nama :..................................................................
TTL :..................................................................
Alamat :.................................................................. Foto 3x4
Pekerjaan :..................................................................
No. Telp :..................................................................

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