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Group or Family Name (Be Creative):
Password:
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Group Captain:
Group Captain Age:
Address:
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Primary team contact for notifications of prizes (contact must be 21 years of age or older):
Name:
Email:
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In the event your team is a Grand Prize winner, the name and email of the Primary team contact may be requested by news media. If you do not wish this information to be shared, indicate by checking this box
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Team Members	Name	Age	Relationship to Group Captain
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