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Each tick mark is one unit 1 dy dx 57358 2 dy dx ...
I accept my child ride s at hisher own risk RIDER...
Tick if this is the initial certi64257cate for th...
Tick boxes as appropriate and specify NA where no...
You may be able to provide evidence of this throu...
1 Please tick wherever applicable 2 Complaints in...
Male Female own and countr of birth Home address ...
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