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* 1. Full Name

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* 2. Age

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* 3. Email Address

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* 4. Upload Your Trick Shot Video Here!

PNG, JPG, JPEG, GIF file types only.
Choose File

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* 5. Do we have permission to upload your video to the Central Goldfields Youth Pages on Facebook and Instagram?

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* 6. Have you liked our Facebook and Instagram pages? All entrants must like our social media pages to be in the running!
Like Us on Facebook: https://www.facebook.com/CentralGoldfieldsYouth

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