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Kearah's Place
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DANCE COMPETITION
Please fill out this form below to register for the dance competition sponsored by Kearah's Place.
First name
*
Last name
*
Phone Number
*
Email
*
Individual ($100.00)
Group ($200.00)
Church and Pastors Name
Comments
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Kearah's Place Inc.
(Main Administrative Office)
945-F West Andrews Avenue
Henderson, NC 27536
Phone: 336-290-4040
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