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["第２３回　全九州卓球選手権大会（ラージボールの部）\n　棄権届け"]
["［シングルス］"]
["種　目","名前","所属","棄権の理由"]
[]
[]
[]
["［ダブルス］"]
["種　目","名前","所属","棄権の理由"]
[]
[]
[]
[]
[]
[]
[]
["上記のとおり棄権等が生じましたのでお届けします。       "]
[]
["令和４年　　月　　　日"]
["鹿児島県卓球連盟　御中",null,"℡　099-248-7091","Fax　099-248-7092"]
[]
["　　　　　県卓球協会（連盟）",null,"℡　（　　　）　　　　-"]
["会長",null,null,"印"]
["届出責任者  "]
["連絡先"]
["＊申込期限後の変更は認められませんので、ご留意ください。"]
["＊棄権が生じたときは、直ちに本紙により提出ください。（ともにＦＡＸ可）"]
["＊ＦＡＸによる届けの場合は､必ず着信確認の電話をお願いします。"]