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Ts' Names Home Cell/Alt. Phone: E-mail address BirthDate (Mandatory) B: Proof: Care Card: Other: Witnessed: Initial dd/Month/yy (Mandatory) Pertinent Medical Information: Care Card #: Doctor Name: Doctor's Phone: Medical or other Information pertinent to Registrant: C: Status:The following must be Swimming: Have you achieved a National Qulifying Time in any non-BCSSA Meet? Y / N Have you participated in any Water Polo Activity listed in the current BCSSA.

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