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Connecticut State Grange P. O. Box 1393, Glastonbury, CT 06033 (860) 6337550 www.CTStateGrange.orgContact Information Liability Waiver/Release Form I do hereby consent and authorize The Connecticut
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Box 1393 in Glastonbury, CT, refers to a specific P.O. Box used for mail delivery, typically by a business or organization.
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Information such as the name of the individual or business, contact details, and any relevant identification numbers must be reported.
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