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Get and Sign CENTRAL AVENUE CHRISTIAN REFORMED CHURCH 2016-2022

Get and Sign CENTRAL AVENUE CHRISTIAN REFORMED CHURCH 2016-2022

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Illness. CENTRAL AVENUE CHRISTIAN REFORMED CHURCH 259 Central Ave Holland MI 49423 Liability and Risk Waiver/Youth Permission Slip/Medical Information Form For overnight activities traveling in church van/vehicle high adventure activities and field trips September 2015 through September 2016 Minor s name Date of birth Sex M/F Allergies food drugs insects etc Medications name dosage reason Other information injuries etc. Insurance Carrier Group or ID Child s doctor Home phone Phone Work Cell ...
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