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ビームライフル射撃教室 申し込みフォーム

受講期間 ※期日外の申込は無効
氏名
ふりがな
年齢 歳
連絡先(電話番号)
連絡先(メールアドレス)


（確認のため再度入力）
刈谷市内在学・在勤の場合は、その名称
刈谷市内在住の場合は、町名
保護者氏名
(高校生以下の場合、保護者の同意が必要です。)
同意確認
射撃経験
備考＆
メッセージ
受領確認 必要 不要
以上で
よければ		 控えを保存する。 （自分のアドレスへ写しを送信します。）
（この写しが届かない場合はアドレスが間違っている可能性があります。）

  

 

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