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Applicant
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Ainm(as Gaeilge):
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Date of Birth:
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Address:
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Home Tel:
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Gender
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Existing Member:
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M
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F
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Mother
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Name:
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Mobile:
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Father
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Name:
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Mobile:
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School
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School Name:
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Class:
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Medical
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Does your child suffer from any known medical condition?
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Y
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N
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Details:
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Special Needs
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Does your child have any special Needs?
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Y
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N
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Details:
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Player
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I agree to abide by the rules of the Carraig na bhFear
Juvenile GAA Club
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Y
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N
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I agree to contact a trainer/mentor if I am unavailable
for training/matches
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Y
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N
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Parent/Guardian
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I agree to allow use of images in club publications and
the club website
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Y
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N
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I am available to assist with various activities in the
club
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Y
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N
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I give my consent for the administration of any medical
treatment as may be deemed
necessary by competent medical personnel
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Y
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N
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