PANITIA PELAKSANA

LIGA BASKET ANTAR SMA SESI I

( LIBAS I 2023 )
Sekre : Gor Tribuana Jl. Diponegoro No. 59 Pekanbaru Telp Wa : 081276846029

FORMULIR PENDAFTARAN
Nama Sekolah : .................................................................................Putra /
Putri
Contact Person : 1) .........................................., 2) ...........................................
Pelatih : ................................................................................................
Asisten Pelatih : ................................................................................................
Official : ................................................................................................
Kostum Basket : Terang ...................................., Gelap ...................................

No Nama Kelas Tahun Keterangan

1 ALIFIA SYAWALANI. A XII 2004
2 ORVILA EGITRI XI 2006
3 RISKA AULIA PERTIWI XI 2006
4 AULIA SALSABILA PUTRI X 2006
5 NUR INTAN RAMADHANI X 2006
6 KEISYA BELVA FILLIA X 2006
7 MOUDY JULYMAL. P X 2007
8 RAHMA SYAKIRAH X 2007
9 NESHA MEIRIEL PUTRI X 2007
10 BUNGA AZ-ZAHRA. D X 2007
11 FEBRIYANI X 2007
2007
12 INSANYA CAMELIA. C X

Pekanbaru,…… Februari 2023

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Manager/Pelatih