Thursday 26 November, 2015
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Member Registration

All questions below are mandatory unless marked with an asterisk (*). Please double check and ensure your email address is correct. This information will be used as the basis for your event entries so please complete bearing this in mind.

Gender: Male
First name:
Last name:
E-Mail Address:
Confirm password:
Date of Birth:

Mobile phone:
Organisation/Club (if applicable) *
Do you have any medical conditions? No
If yes, please describe the condition(s):
Emergency contact name
Emergency contact telephone
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