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• First name ^*
• Last name ^*
• Telephone
• Address ^*
• Age ^*
  - please select -13 to 18Over 18Other

  Please specify: ^*
• Are you intersted in coaching?

  For yourself or a member of your family

  Yes No I (or family) have had coaching recently at the club
• Team play

  Would you like to be kept informed of opportunities?

  Yes No
• Competitions

  Are you interested in competing against other club members in competitions?

  Yes No