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Personal Information:

First and Last Name*
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Address (Street, City, State, Zip)*
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Email*
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Phone Number*
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Age*
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Names of additional attendees:
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Church Information:

Name of Church*
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Church Address (Street, City, State, Zip)*
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Phone Number for Church*
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Church Email Address
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Pastor's Name*
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How many People are you registering?
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Where We Are Located

 

We are located 30 minutes on the southeast side of Cincinnati

3052 State Route 132,
Amelia OH. 45102

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