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Gold Cup Derby Registration
Please fill out a separate form for each participant
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Email
*
Your email
Name
*
Your answer
Age
*
Your answer
Legal Guardian (If under 18)
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Physical Address
Your answer
I have payed for my car kit and registration ($10 for adult, $5 for teen/child) at
https://bereanag.org/give
*
Yes
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