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Membership
Details
Terms & Conditions
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Confirmation
Your Personal Details
Club
Kaiapoi
First Name
Last Name
Date of Birth
Parent Name
Gender
Male
Female
Email
Password
Confirm Password
Cell Phone
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City
State
Postal Code
Country
New Zealand
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Child Care
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Emergency Contact
Name
Phone
Email
Relationship
Medical Information
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Start Date
First Payment Date
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Membership
Multi Regular 3 months
Price
$260.00 Full Cost
Tag
$20.00
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$0.00 until
Account Credit
applied after signup
Membership Start Date
Membership Length
3 months
Prorated Upfront Fee
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