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["中央学院高校サッカー部行　ＦＡＸ０４－７１８８－４１３０"]
[]
[]
[]
["中央学院高等学校サッカー部　練習参加申込書"]
[]
["参加希望日時"]
["第１希望日","第２希望日","第３希望日","第４希望日"]
[{"$nulls":7},"2021年","月","日","現在"]
["フリガナ",{"$nulls":5},"生年月日","年","月","日","(　　)歳"]
[]
["氏名"]
[{"$nulls":6},"利き足",null,null,null,"足"]
[]
[null,"〒",{"$nulls":4},"〒"]
["現住所","自宅住所",{"$nulls":4},"中学校住所"]
[{"$nulls":6},"TEL"]
["電話番号","自宅",{"$nulls":4},"携帯"]
["現所属　　クラブ",{"$nulls":5},"フリガナ"]
[{"$nulls":6},"監督名"]
[{"$nulls":6},"携帯"]
[{"$nulls":6},"フリガナ",null,null,null,"クラス"]
["中学校","立",null,"中学校",null,null,"担任"]
[]
[]
["ポジション","①第一希望",null,null,"②第二希望",null,null,"③第三希望"]
["（右左）"]
[null,null,null,"cm","/",null,null,"kg"]
["身長/体重",{"$nulls":7},"５０ｍ走",null,"秒"]
[]
["（必　修）"]
["戦歴"]
["選抜歴"]
["アピール"]
["ポイント"]
["など"]
[]
[{"$nulls":7},"（本人記入）"]
[]
["【参加承諾確認書】",null,"（参加前日までにＦＡＸ送信！当日持参し提出して下さい！）"]
[]
[null,"中央学院高校サッカー部練習体験会に参加するにあたり以下の内容についてご確認下さい。"]
[]
[]
["1、","ご記入いただいた個人情報につきましてはプライバシーの保護により、本人、中央学院高校、中央学院大学以外の第3者には公表いたしません。"]
[]
[]
["2、","この練習体験会に起こった怪我、盗難また移動中に起きた事故等について中央学院高校では一切の責任を負いかねますのでご了承下さい。"]
[]
[null,"（応急処置は致します）"]
[]
[null,"上記の内容を了承し、練習体験会に参加することを承諾いたします。"]
[]
[null,null,null,"選手氏名"]
[]
[]
[null,null,null,"保護者氏名",{"$nulls":4},"㊞"]
[]
[]
[{"$nulls":7},"中央学院高校ＦＡＸ０４－７１８８－４１３０"]