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Contact Us

  • Phone: (813) 626-5383
  • Email: 
  • Mailing Address: 11605 U.S. Hwy 92 East, Seffner, FL 33584
  • Senior Pastor: Will Beauchamp

 

 

VBS Sign Up

VBS Form
Contact Information

Address

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Please provide a number where you can be readily reached.

Please list anyone who may be picking up your child at the end of VBS each day.

Child Information

Name of Child Attending VBS

Select the highest grade your child has completed in school as of June 2019.

Age of your Child

Please list any food allergies or other medical conditions your child has here.

Child Information - 2

(Optional)

Please fill out this section if you have a second child attending VBS.

Name of Child Attending VBS

Select the highest grade your child has completed in school as of June 2019.

Age of your Child

Please list any food allergies or other medical conditions your child has here.

Child Information - 3

(Optional)

Please fill out this section if you have a third child attending VBS.

Name of Child Attending VBS

Select the highest grade your child has completed in school as of June 2019.

Age of your Child

Please list any food allergies or other medical conditions your child has here.

Emergency Contacts

The best contact in the event of an emergency.

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The best contact in the event of an emergency.

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Your divider description here.

If yes, where?

May we have permission to photograph your child?

May we have permission to use your child's photograph for the purpose of promotion?