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| 集合場所・時間 | 宮崎市街地 | 行動予定
（自由記述） | スタート地点 10:39 - 11:13 大浪池休憩所 11:16 - 11:48 大浪池 - 12:08 韓国岳避難小屋 13:10 - 13:53 大浪池休憩所 11:59 - 14:26 大浪池登山口 - 14:26 ゴール地点
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氏名 /
役割
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生年月日 /
血液型
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住所
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携帯電話 /
緊急連絡先
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山岳保険 /
ココヘリID
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