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Permission slip


CHURCH PERMISSION SLIP AND CHURCH HEALTH FORM  TO WHOM IT MAY CONCERN:  Childs Name:____________________________________________ has my permission to go 
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Document Date: 2014-05-04 23:58:25


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Facility

Maranatha Worship Centre of Dayton / Maranatha Worship Centre / /

MedicalCondition

Minor’s Birthdate_______________________________________ PLEASE LIST ANY ALLERGIES / ALLERGIES / /

Organization

Maranatha Worship Centre / /

Position

qualified physician / /

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