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Registration Form

Southern States Chicken Wing Eating Championship*
Pine Bluff, Arkansas

September 16, 2006

 

Name:
Moniker/Nickname:
Phone:
Address:
Email:
Height:
Weight:
Interesting Fact About Yourself:
Why do you want to be in this eating competition:
Why I deserve to be considered for this prestigious event:

* Must be 18 or older to enter event

 

 

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