Individual Registration — UIPM Prachuap 2026

Personal Info

First Name (EN) *

Last Name (EN) *

Gender *

Date of Birth *

Nationality *

UIPM ID

Email *

Phone

T-Shirt Size *

Disciplines Entered *

Pick one or more — the flat fee covers all disciplines

Biathle Run - Swim - Run Sat 5 Dec 2026

Triathle Swim - Shoot - Run Sun 6 Dec 2026

Laser Run Run - Laser Shoot Sat 5 Dec 2026

Club / Affiliation

Has affiliation

No affiliation

Documents

ID Card / Passport *

Click to upload (jpg, png, pdf)

Photo *

Click to upload (jpg, png, pdf)

Entry Fee

1,000 ฿

Covers Biathle / Triathle / Laser Run

Payment Channel

ธนาคารกสิกรไทย

Account No.: 236-3-51945-0

Account Name: นายวิโรจน์ โลห์ทอง

After transfer, also send the slip in the event LINE group with your name

Payment Slip *

Click to upload slip (jpg, png, pdf)

Consent Letter

Parent or coach must sign a consent letter for participation

Upload Consent Letter *

Click to upload (jpg, png, pdf)

Signature / Contact of parent or coach *

Competition Rules

I accept the UIPM and organizer competition rules

I do not accept