Please complete the following:

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* 1. The Sporting Memories participant’s name

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* 2. Name of the participant’s Sporting Memories Club

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* 3. If you are applying on behalf of a participant: 

Your name

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* 4. I am (you can select more than one option):

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* 5. Email address to which our update and weekly digital edition of the Sporting Pink should be sent:

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* 6. Please tick:

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