Kapunda Youth Registration 2020
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What's your first name? *
What's your last name?
What's your date of birth? *
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DD
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How old does that make you?
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What's your year level at school? *
What's your street address? *
What town/suburb are you from?
What's your postcode?
What's the name of a parent/guardian we can contact in an emergency? *
What's the best contact number for your parent/guardian? *
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