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	First name:	Last name:

	Street address:



	Town / City:	State / Province:

	Postal / Zip code:	Country:

	Email address:

	Work phone number:	Work phone number:


Check if Registration Mailed:

Check if Registration Faxed:
	Please list Class Number and Description:

	A.E.F No. (Alberta Equestrian Federation):

'; wspFN_1781013458_15924_59 ( wspVAR_1781013458_15924_58 );