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* 1. What is your gender?

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* 2. What will your Licence Category be in 2019?

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* 3. What is your first name?

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* 4. What is your last name?

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* 5. Which rounds are you avaialble

  Yes No
22nd September - Vic Park
6th October - Wallarroo
7th October - Moonta
20th October - Vic Park
28th October - TTT
10th November Criterium TBA
18th November - Criterium Murray Bridge
9th December - Criterium - TBA

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* 6. What Club do you ride for?

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* 7. What level are you currently racing?

T