%3Cspan%20style=%22color:#000;font-size:15px%22%3E%3Cspan%20style=%22color:#000;font-size:16px%22%3EPlease%20register%20below%20using%20your%20full%20legal%20name%3C/span%3E%3C/span%3E
First Name
Last Name
Birthdate (MM/DD/YYYY)
Email
Password
Confirm Password
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