Wheelchair Sports, Inc.

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Wheelchair Sports Membership Form

Welcome to Wheelchair Sports, Inc. on line sign up, please fill out the form if you are interested in joining. We are currently seeking disabled and able-bodied persons for participation in our organization. Please DO NOT confuse this with the website login!

*First Name

*Last Name

Age

Street Address

Address (cont.)

City

State/Province

Home Phone

*E-Mail

Personal URL

Select any of the following sporting events that interest you:

Type of Disability

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