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Tarts at 8am Hoerskool Birchleigh cnr Maroela & Olienhout Ave, Birchleigh, Kempton Park Name & Surname: .......................................................................................... ................. . Age: . Gender (Male/Female): . Company (if applicable for teams): Tel: CeII: . E-mail: . Address: . R30 (Thirty Rand entry fee to participate in the SHAZ Family Cancer Walk. Prizes will be awarded to: 1) Largest group entry Pre walk entries accepted - On the day regis.

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