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Star Acadie Home | Participant's Release Form
Application Form | Rules and Regulations

Participant`s release form

  Name:

  Surname:

  Date of Birth: / /

Year       Month     Day

  Age:

  Address:

  Town:

  Email:

  Contact numbers:

  Home:

  Cellular:

  Name of parent or guardian
  (If under 19 of age) :

Village de Cap-Pelé inc.
33 ch. St-André
Cap-Pelé, NB, Canada E4N 1Z4

Tel. : (506) 577-2030
Fax : (506) 577-2035
Email : cappele@nb.aibn.com

© 2012 Cap-Pelé inc.
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