Jom! Live With Vitality Registration

Jom! Live with Vitality Registration

Join us at JOM! LIVE WITH VITALITY on 11 June 2022 at Laman Cergas AIA Vitality, Taman Metropolitan Kepong. We have a lot of interesting activities and you may get a chance to win our grand prize - Gintell running treadmill with our lucky draw.

All fields marked with * are mandatory.

Full name as per NRIC / Passport*

NRIC / Passport Number*

NRIC/Passport number is invalid

Email address*

Email is invalid

Phone

Invalid phone number

Agent code

You may also register a maximum of two (2) participants aged 17 and below to attend JOM! LIVE WITH VITALITY with you on 11 June 2022.

Fill in the details below if you are interested:

Child 1

Full name as per NRIC / Passport

NRIC / Passport Number

NRIC/Passport number is invalid

Child 2

Full name as per NRIC / Passport

NRIC / Passport Number

NRIC/Passport number is invalid

I confirm that I am 18 years old an above, and I have read, understood and accept the Terms & Conditions of this Event. I agree that any personal information collected or held by AIA Malaysia may be disclosed by AIA Malaysia to its selected (Note. Please refer to AIA Malaysia Privacy Notice @ https://www.aia.com/en/index/privacy-statement.html for further details)

I agree and consent to my personal information or details being processed and used by AIA Malaysia for the purpose of marketing and publicity notification/information for its product.

Thank You!

Your submission has been received.