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Get KY KHSAA GE04 2012-2024

L Examination Form/Consent and Release PART I - ATHLETE INFORMATION (This part must be completed by the student) Name (Last, First, Initial) Home Address (Street, City, State, Zip): Gender Grade Date of Birth: Attendance History Grade School Name 9 10 11 12 School Year School Birth Place (County, State): School Year I am planning to participate in the following (circle all you might try to play): Baseball Basketball Cross Country Football Golf Soccer Track and Field Volleyball Wrestling Archer.

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