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2017 SR-9 GATHERING April 21-23 2017 Camp Frank G. Lumpkin LaGrange GA PARTICIPANT REGISTRATION FORM Memorabilia Form Due Date February 1 2017 No orders will be accepted after this date. Item Price Qty Total Delegate Registration Delegate Late Registration paid after 3/29 REMINDER Memorabilia can only be ordered prior to February 1 2017 Heartland Gathering Participant Patch Participant T-Shirt Small Section Habitat for Humanity Patch Total Payment Enclosed. Registration Due Date March 29...

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Lumpkin Lagrange GA refers to the local tax forms for Lumpkin County and Lagrange, Georgia.

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