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For the first time obey God’s command to believe in the name of His Son, Jesus Christ, and to love one another as He commanded us (1 John 3꞉23)
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Memorize 1 John 3:18
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Men’s Dinner (9.9)
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ERBC Beach Day (9.12)
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Women’s 50+ Social (9.18)
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Street Kitchen homeless feeding program (9.19)
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Prayer Gathering (9.21)
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Public Reading꞉ Gospel of Matthew (10.5)
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