June Take Home Box Sign Up

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Thank you for taking a moment to fill out this form so we can better customize a box for your family. Boxes should be available during office hours (9A-4P) June 3 and 4th. If you need an alternate pickup arrangement due to work schedules etc, please contact Nick Hatch or Jamie Evans and we will do our best to accommodate you!

Parent Last Name

Parent First Name

Phone Number

We have Children in:

Toddler Town (Preschool)

Kid City (Elementary)

Both

Number of Toddler Town Kids

Please List Toddler town kids names and ages

Number of Kid City Kids

Please List Kid City kids names and grades

How can we be praying for you?

Comments, Questions, or Concerns

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