6pm @ Foxton SLSC

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* 1. First Name

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* 2. Last Name

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* 4. SLSNZ Membership #

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* 5. Email Address

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* 6. Cell Phone Number

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* 7. Do you agree to provide the following of your own for the training: Flippers, Goggles, Wetsuit, Towel & High Vis-Vest

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