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GTA 2022 JUNIOR STATE CUP
EXPRESSION OF INTEREST FORM
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NAME
*
Your answer
DATE OF BIRTH
*
MM
/
DD
/
YYYY
TEAM TRIALLING FOR (age in 2022)
*
10 yrs
12 yrs
14 yrs
16 yrs
18 yrs
MALE / FEMALE
*
MALE
FEMALE
PARENT/GUARDIAN EMAIL
*
Your answer
PARENT PHONE NUMBER
*
Your answer
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