NOX CUP Registration — BALI PADEL ACADEMY

NOX CUP - PRO - REGISTRATION

PRO Category Registration Form

Personal Information (Player 1)

Full Name *

Gender *

Nationality *

Date of Birth *

Phone / Whatsapp *

Email *

Points / Ranking (FIP/APPT) *

T-Shirt Size *

Personal Information (Player 2)

Full Name *

Gender *

Nationality *

Date of Birth *

Phone / Whatsapp *

Email *

Points / Ranking (FIP/APPT) *

T-Shirt Size *

Payment

End the registration process with the payment using the following information:

Price: 30 USD or 500,000 IDR
Beneficiary Account: BALI PADEL ACADEMY PT
Beneficiary Bank: PT BANK CENTRAL ASIA TBK
Swift Code: CENAIDJAXXX
Branch: KCP Kerobokan 7700
Branch Address: Jln. Raya Kerobokan No. 24, Kuta Utara, Badung, Bali 80361, Indonesia
Country: Indonesia
USD Account #: 7700695730
IDR Account #: 7700695721

Payment Proof (Required, Screenshot of the payment)