Sledge was born on November 25, 1941, in Leighton, Alabama. He worked in a series of agricultural jobs in the fields in Leighton, before taking a job as an orderly at Colbert County Hospital in Sheffield, Alabama. Through the mid-1960s, he toured the Southeast with the Esquires Combo on weekends, while working at the hospital during the week. A former patient and mutual friend of Sledge and record producer Quin Ivy introduced the two. An audition followed, and Sledge was signed to a recording contract.
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