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CELESTIAL
FIRE CHURCH
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Registration Form
First Name
Last Name
Phone Number
Church you Attend
Pastors Name
Emergency Contact Name
Emergency Contact Phone Number
Do you have any medical problems for which you may need medication?
Yes
No
If you answered "yes", please explainthe medical problem, medication, and how many times a day it must be taken:
Please pay in cash to one of our leaders.
Register
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