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OMEGA GOSPEL MINISTRIES

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KIDS DESTINED FOR GREATNESS

ENROLL WITH US AT OMEGA ACADEMY OF EXCELLENCE DAYCARE

Childs First Name

Email Address

Childs Last Name

Child's Date of Birth

Does your child have an insurance coverage *

No

Yes

Have you lost your consciousness in the last past 12 months? *

No

Yes

Initials

Today's Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

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