Gender
Select… Male Female
School
Select… Alafia Elementary School Apollo Beach Elementary School Brooker Elementary School Bevis Elementary School Bing Elementary School Boyette Springs School Buckhorn Elementary School Center Academy Cimino Elementary School Collins Elementary School Colson Elementary School FishHawk Elementary School Lamb Elementary School Limona Elementary School Lithia Springs Elementary School Mintz Elementary School Nelson Elementary School Riverhills Elementary School Riverview Elementary School Seffner Christian Academy Seffner Elementary School Sessums Elementary School Stowers Elementary School Trapnell Elementary School Valrico Academy Valrico Elementary School Winthrop Charter School Barrington Middle School Burns Middle School Bell Creek Academy Center Academy Florida Virtual School Franklin Middle School Mann Middle School Mulrennan Middle School Randall Middle School Rodgers Middle School Seffner Christian Academy Stewart Middle School Valrico Academy Winthrop Charter School Armwood High School Bloomingdale High School Bell Creek Academy Brandon High School Center Academy Durant High School School Florida Virtual School King High School School Middleton High School Newsome High School Riverview High School Seffner Christian Academy Strawberry Crest High School
Grade
Select… Pre-K Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade
Medical Note
List any conditions, allergies or special needs
Child's Siblings
List first and last names
Photo Release *
During Kids Ministry programming/events, photos and videos may be taken. These photos can be used for promotional materials. Material will NEVER include the names of the children in the videos or photos as per our Child & Youth Protection Policy. I give permission for still or video pictures to be used for promotional purposes.
Select… Yes No
My child would like more info on using his/her gifts to serve as a(n)
Submit