REGISTRATION FORM Tobe eget y Pare) Guardan eat PLEASE RINT GIRLS RURAL Peace ern your registration wth the $15 annual membership fee (Money Orers oy!) ‘GIRLS INFORMATION tas name fot ML tee sont Ate sowtnenne # oy se » oat sar Sted te Seinunte ecasdalcne ta es Waberirdon —T)brardan cer oT eR, pe ty MOTHER'S INFORMATION lastname Fe Mee see As rere # Prone Eanes Ener ccapaten Wor Pe FATHER'S INFORMATION lastname Fret mae Ses ess doweretnt ow Stale a Prone Eat adss rel ‘capaten We Pern EMERGENCY CONTACT ane fessntie DDISGIATNER AND SIGNATURE Werden ht whe partcitng Gis rl aches he regsbat maybe potahe eB veo decreas. We undead at eg yb i wort mts Pea Se a rs, We sane He aan Pe ‘Sete caeI} EMERGENCY & MEDICAL INFORMATION 1H “Tobe completed by Paren/Guaran Gime RURAL GIRL'S INFORMATION a =a — oe ace Seer cet rey el tenets eae ome woe ae l= eT SE Sern Eni Cod <4 et i ro = Phage oeeerrHSrCEae a =e arrow : (MEDICAL INFORMATION estan Preteence “Pivicarstens Pre aber ‘anc Company Rae Riri Mean Carers a ater mal ap sgl varnrtyboratary, sneha. nd ober adel ana eet pocaaires may bt bated ar pesca yan ends paraneses ry car wwe ny at tae careea Team ‘wer pos oy nbs ev bat eer aeniparan be athedn ace tS anager “PaceteGoarians Sane Dae |e pares omy cht oo fl tps release Gir Raa rm aby nase facet ring Btn alate {SC ra song oe nomal ety proces have ben taken Peer atuadare Sraie z ‘Wines Sno Dae