Registration – Cysa Joca

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First Name

Last Name

Street Address

Address Line 2

City

Province

Postal Code

Phone

Picture (recent face shot for judges' only) *

Allergies or Food Restrictions

Yes No

DOB

Topic

Language of Delivery

Junior Competition ($20) Senior Competition ($40)

$20

$40

Acceptance

I understand that I will not be considered as an applicant until CYSA Inc. has received my entry fee. you will be redirected to PayPal upon pressing Submit & Pay. I also understand the rules and regulations of the competition, and agree to abide by them and accept the prizes as awarded

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CYSA Inc. is funded in part by:

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