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Mail form and payment to: MS Assemblies of God Women's Ministries Dept. PO Box 720309 By ram, MS 39272 CONTACT INFORMATIONPLEASE PRINT Students Name Age Know Allergies/ Medical Conditions Parent×Guardian
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Mississippi Womens INFORMATIONPLEASE childs Byram indemnify TRANSFERABLE Assemblies Ministries refundable Workshops utilized reproduced submitting Dept certify payable executing promotional trustees participating

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