Malaysia Strongest Man 2023 Registration Form (For Malaysian Athletes Only) Name(Required) First Last Gender(Required) Male Female IC Number(Required)Tel/Mobile Number(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email(Required) Weight (in KG)(Required) Height (in CM)(Required) Category(Required) Strongman - Male Open Strongman - Female Open Strongman - Male Novice Strongfit - Male Open Strongfit - Female Open Strongeat - Male Open Strongeat - Female Open Strongeat - U18 Open Strongarm - Male Open Strongeat - Female Open Strongkid - U18 Open Please select your categoryFee Amount T-Shirt Size(Required)XSSMLXL2XL3XL4XL5XLPlease select your t-shirt sizeAny medical history or injuries?(Required)YesNoIf 'YES', please eloborate Emergency Contact Number(Required)Please state a contact number in case of any emergenciesEmergency Contact Person Name & Relation(Required) Name the person to contact in case of emergencies. Please mention your relation to this person.I authorize the Organizers, where it is impractical to communicate with me or my Emergency Contact, to arrange for me to receive such medical or surgical treatment as determined by the paramedical or medical officers on-site or on duty during any event or activity. I further authorize the use of Ambulance and/or anesthetic by a qualified medical practitioner if in his/her judgement if it is necessary. I accept responsibility for payment of all expenses associated with such treatment. I appreciate that every care will be taken by the Organizers and those connected with the Organizers cannot be held responsible for personal injury, loss or theft of property affecting me.(Required) Yes, I agree to the above Medical Authorization I consent to be photographed and/or filmed/video recorded. I understand that the image may be displayed in the Organizers publications, facility or website. We understand that as a precaution my name will not be published or linked with photographs without prior permission from us; and that the Organizers will ensure appropriate non-disclosure of information.(Required) Yes, I agree to give permission The Organizers, and Malaysia's Strongestman Association and all of it's sponsors and partners cannot be held liable for any incidental or consequential damage, loss, medical incident or death. This limitation of liability exists regardless of whether any claim made against the Organizers arises in tort or in contract, including any claims based on negligence and cannot be modified or extended except by an explicit written agreement from the Organisers.(Required) Yes, I agree to the above Indemnity Agreement I have read and agreed to the terms and conditions, and to abide by all rules and regulations set out by the Organizers. I will proceed with registration.(Required) Yes, I agree to the above Acceptance and Acknowledgement
