50/50 Raffle Form

Name *

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Last

Email *

Phone *

Address *

Address Line 1

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Tickets - Select the number of Tickets you want to purchase *

Total

$0.00

The proceeds from this Raffle will be split between the Children's Miracle Network and KSDS. Tickets should be mailed to you within 3 days from receipt of the Order Form. Any questions should be sent to: Cindy Reed, luwho08@yahoo.com.

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