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2015 CAPA-WHS Dragon Boat

Application
Personal Information
Student Name ________________________ Gender:
Grade _________
Cell Phone _________________________
Phone________________________
Student Email________________________
______________________________

Upcoming

Home
Parent Email

Weight ____ Height ____ Left or Right Handed (circle one)


Mother Name______________________________
___________________________

Cell Phone

Father Name_______________________________
___________________________

Cell Phone

Emergency Contact:
Name ___________________________
_______________________________

Relationship

Phone ___________________________
Qualifications
School Sport ___________________________________
yes no
Previous dragon boat experience

Varsity

What Year _________________________ Team Name


_______________________________

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