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KRISHNAMURTI WYEE GATHERING 16 to 19 March 2012 REGISTRATION FORM: Required for Insurance purposes as well as normal administrative matters; not least for catering. Fill out and send back via email or post to: Terry O'Brien 17/4 Michigan Road, Riverwood, NSW 2210 FIRST NAME.................................... SURNAME...........................................
ADDRESS...................................................... ............................................................. ...........
TELEPHONE NO. ........................................ MOBILE: ...................................................... EMAIL: ......................................................
IN CASE OF EMERGENCY - WHO TO CONTACT?............................ ................................
RELATIONSHIP............................................ TELEPHONE NO. ........................................ MOBILE: ....................................................... EMAIL: ......................................................... SPECIAL NEEDS?...........................................
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