Form Test – SUN CITY ANTHEM HIKING CLUB

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* Username

*

* First Name

*

* Last Name

*

* Email Address

*

* Day Phone

*

* Address

*

* City*

Select Option

*

* State*

Select Option

*

* Zip Code*

Select Option

*

Emergency Contact Name

Emergency Contact Phone Number

* Password

*

* Confirm Password

*

* I certify that I have a valid Sun City Anthem at Merrill Ranch activity card.

Yes

No

* I have read and accepted the Activities Liability Waiver

Yes

No

* I agree to the terms of membership including the use of photos.

Yes

No

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