REGISTRATION FORM TNI-POLRI First Name Last Name Name on BIB Number Birth of Date Gender Men Woman Blood Type A B O AB Address City Country Identity Number (NIK/SIM/Passport) Email Instagram Mobile Phone Number Emergency Contact Number Emergency Contact Name Do you have insurance ? Yes No If Yes (Name Insurance) Jersey Size Chart Size Chart XS S M L XL 2XL Community / Club Race Fee INDONESIAN >>Choose Your Category<< 10 KM-TNI - POLRI ( IDR 440,000 ) 25 KM-TNI - POLRI ( IDR 480,000 ) 50 KM-TNI - POLRI ( IDR 720,000 ) Payment Terms and Conditions If you are a 2023 BLOT participant, you can download your BLOT 2023 race certificate here: Download Certificate Upload Race Result (Upload Hasil Lomba) Upload Payment Receipt (Upload Bukti Pembayaran) File Waiver File PAR-Q Payment (BSI Bank Syariah Indonesia - 7205659147 - ARRAS ADVENTURE), Please Upload Your Proof of Transfer Submit *WAIVER & PAR-Q Send to Email : blotarrasadventures@gmail.com Waiver PAR-Q
