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FOR OFFICE USE ONLY _____ Pre- Registration Fee ($15) _____Late ($20) _____ Release/Waiver Form
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Document Date: 2014-05-20 15:23:41


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City

Falls / /

Currency

USD / /

Facility

Dance Studio / University attended/attending / /

Organization

Wellness Center Website School / EDUCATIONAL/CAREER HISTORY College / /

Person

Lyndsay Talcott / /

Position

Force Dancer / /

ProvinceOrState

South Dakota / /

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