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["西教様式 05s"]
["西日本ｽﾉｰﾎﾞｰﾄﾞ技術選手権大会",{"$nulls":30},"申 込 書"]
[]
[null,"提出日",{"$nulls":7},"年",{"$nulls":3},"月",{"$nulls":3},"日","（西暦で記入）"]
["　　大会参加に関しては、損害事故防止に十分注意するとともに、万が一私が原因で発生した事故に対して、"]
["　すべて私の責任において処理することを承諾の上、参加を申し込みます。"]
[]
["会  場  名",{"$nulls":7},"　　　女鹿平温泉　めがひら   スキー場"]
[]
["＊受  付  日",{"$nulls":12},"年",null,null,"月",null,null,"日",null,"＊参  加  料",{"$nulls":7},"領   収",{"$nulls":4},"・","未   収"]
[]
[]
["ﾌ ﾘ ｶﾞ ﾅ",{"$nulls":24},"性   別",{"$nulls":5},"男",{"$nulls":3},"・",null,"女"]
["氏       名"]
[]
["生 年 月 日",{"$nulls":12},"年",{"$nulls":3},"月",{"$nulls":3},"日生",null,null,"満年齢",{"$nulls":13},"才"]
[]
["カテゴリー",{"$nulls":7},"アルペンスタイル　　　　　　　　　　・　　　　　　　　　　フリースタイル"]
[]
["加盟団体",{"$nulls":20},"所属団体"]
[]
["ＳＡＪ会員登録№",{"$nulls":16},"スキー保険",{"$nulls":15},"保険№"]
[]
["住      所",{"$nulls":7},"〒"]
[]
[]
["電話番号",{"$nulls":14},"-",{"$nulls":4},"-"]
[]
[]
["取得資格",{"$nulls":7},"・","2 　級",{"$nulls":6},"年",null,null,"月",null,null,"日","取得",null,"主管県連"]
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[{"$nulls":8},"・","クラウン",{"$nulls":6},"年",null,null,"月",null,null,"日","取得",null,"主管県連"]
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[]
["上記「個人情報」については、プログラム、行事運営及び事業報告書のみに使用することを同意します。"]
["＊様式のセルを連結させるなど独自に改造しないで下さい。"]