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* 1. Name of participant (first name)

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* 2. Email address where we can update you

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* 3. Your phone number

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* 4. What particular activity or sports interests you most?

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* 5. Do you have any physical challenges?

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* 6. What types of sports programs have you been in before?

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* 7. Do you have any mobility issues?

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* 8. What days work best for you? Pick as many as you like.

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* 9. What time of day works better for you? Pick as many as you like.

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* 10. If we were to operate in any of the following recreation centers, which would you prefer? Pick up to three please.

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