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BUDDY Sleepover 2012 - Registration
Please fill in this registration form to enter BUDDY 2012 Survivor Sleepover!
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* Indicates required question
Full Name
*
as in IC
Your answer
Age
*
Your answer
Gender
*
Choose
Female
Male
Email Address
*
Your answer
IC Number
*
including dash (-)
Your answer
Mobile Phone Number
*
Your answer
House Phone Number
*
Your answer
Any Vegetarian / Special Diet?
If none, leave blank; if yes, please specify.
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Medical Conditions
Allergies, diseases, and/or recurring health problems.
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Parent / Guardian Information
Parent / Guardian's Full Name (1)
*
Your answer
Mobile Phone Number (1)
*
Your answer
Relationship with Parent / Guardian (1)
*
Choose
Father
Mother
Uncle
Aunt
Guardian
Parent / Guardian's Full Name (2)
*
Your answer
Mobile Phone Number (2)
*
Your answer
Relationship with Parent / Guardian (2)
*
Choose
Father
Mother
Uncle
Aunt
Guardian
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