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REGISTRATION Weekend/Day Programs Program: ____________________________________ Date: _________________ ____________________________________ _________________ ____________________________________ _________________ Number attending: ________ Registration fee: ________ Amount enclosed: _________ Name __________________________________________________________ Address ________________________________________________________ City ________________________ State ____________ Zip __________________ Home phone ______________________ Work phone _____________________ Sister Jacqueline
LeBlanc, p.m.
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