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Refuge D-Now '19


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Imprint Student D-Now ‘19

February 15 - 17

$60 Per Student.

Pay to Jeff Glenn or at the church office.

Reserve your spot by filling out the form below ▾

Deadline for Registration is Feb 10

Student Name *
Student Name
Male or Female?
Parent or Guardian's Name
Parent or Guardian's Name
Phone
Phone
Address
Address
Parent or Guardian's Phone
Parent or Guardian's Phone
Name of Friend you would like to stay in a host home with?
Name of Friend you would like to stay in a host home with?
What T-shirt would you like?
(all adult sizes)
Earlier Event: February 1
R.A.'s Pinewood Derby