SAMFIRE FC

New Member Registration Form

Personal

Category

Documents

Account

Personal Information

Full Name (as per IC) *

IC Number * Without dash (-), 12 digits

Date of Birth Required for Youth category

Email *

Phone Number *

Gender

Address

Member Category *

Youth Member (Under 18)

RM 5.00 / year

Samfire Member

RM 20.00 / year

Committee (AJK)

RM 50.00 / year

Honorary Member

RM 500.00 / year

Player Info (if applicable)

Position

Jersey No.

Documents & Photo

Both documents are OPTIONAL. You may skip to the next step.

Profile Photo (Optional) JPG/PNG, maks 5MB

IC Copy (Optional) PDF/JPG/PNG, maks 5MB

Account Password

Password * Minimum 8 characters

Confirm Password *

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