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Antioch Baptist Church Registration
**MASKS REQUIRED**.
If you need assistance completing this form or prefer to register via phone, contact
antioch640@comcast.net
or call (973)-379-1465
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Email
*
Your email
Full Name
*
Your answer
Phone Number
Your answer
Total Number Attending
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Please enter the name of each attendee.
*
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Will you or any attendee require handicap access?
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