| Date Created | September 14, 2023 |
|---|---|
| Participant's Name | Keilani Tau’a |
| Participant's Age | 17 |
| Parent/Guardian Name | Adam Tau’a |
| Parent / Guardian Cell Phone Number | (801) 631-0422 |
| Parent / Guardian Email | Email hidden; Javascript is required. |
| Team Placement | Holomua Team |
| Parent E-Signature | Adam Tau’a |
| Date | 9/14/2023 |
| Participant E-Signature | Keilani Tau’a |
| Date | 9/14/2023 |