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REGISTRATION A NEW MEMBER

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Language*

Division / Charpter*

Road Name / Nickname*

Enter your name here that should be on your future cut.

Identification Number*

Full name*

Bhirthday*

Month

Day

Year

Endereço de várias linhas

Country/Region*

Address*

City*

Zip / Postal code*

Phone*

Email

Profession*

Emergency Contact

Emergency Phone

Sponsor in the club*

Rank Position*

Prospect / PP

Half Patch / Meio Colete

Full Patch

This information should be provided by your division director. Essas informações devem ser orientadas pelo diretor da sua divisão.

T-Shirt Size*

Your Picture / Selfie*

Registration Form

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