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* 1. Name

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* 2. Date of Birth

Date

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* 3. Course of Study

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* 4. Year of study

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* 5. Height (feet)

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* 6. Weight (kg)

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* 7. Sporting Background (Please provide a brief summary of your sporting background to date)

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* 8. Gender

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* 9. UL Student number

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* 10. Email address

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