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| Name: | |
| Postal Address: | |
| Home Phone: | |
| Mobile Phone: | |
| Email: | |
| Playing Ability: | Intermediate |
| Payment method |
Send a cheque for $700.00 payable to Peter Nahuysen |
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(Contact Peter Nahuysen for account details) |
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| ANTI-SPAM: | |
| For more information contact Peter | |
| Back to Introduction | |

