Coffs Harbour City Council

PITCH COMPETITION
REGISTRATION FORM
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business idea or team name

Entrant First Name *

Entrant Last Name *

Entrant Phone Number *

Entrant Email *

Entrant Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

If under 18

My parent/guardian has consented to my entry in Startup Coffs Coast Pitch Competition

TERMS AND CONDITIONS *

TERMS AND CONDITIONS http://sixdegreescoworking.com/2015/03/06/coming-soon/

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Team Member #1 Last Name

Team Member #1 First Name

Team Member #1 Email

Team Member #1 Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Team Member #1 TERMS AND CONDITIONS

TERMS AND CONDITIONS http://sixdegreescoworking.com/2015/03/06/coming-soon/

Team Member #2 Last Name

Team Member #2 First Name

Team Member #2 Email

Team Member #2 Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Team Member #2 TERMS AND CONDITIONS

TERMS AND CONDITIONS http://sixdegreescoworking.com/2015/03/06/coming-soon/

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