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* 1. Which event will you be attending?

Choose all that apply 

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* 2. What is your name?

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* 3. Gender?

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* 4. Year of birth 

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* 5. What is your email address? 

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* 6. Contact Number?

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* 7. Emergency Contact 

If you require more information please contact:
Alison Fothergill
0447 CROQUET / 0447 276 783
Traralgon.croquet.club@gmail.com
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