Request edit access
Christmas For Kids 2017
at Gethsemane Lutheran Church - 4040 N. 108th Street, Omaha, Nebraska
December 9, 2017, 9 a.m. to noon
Please complete and submit a form for each helper or child in your family that will be attending C4K.
Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
Phone Number (xxx) xxx-xxxx *
Your answer
Email Address *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number During Event Dates (xxx)xxx-xxxx *
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Current Grade *
Permission to Photograph *
Permission to Attend *
Allergies for any children: *
Describe Allergies:
Your answer
How did you hear about Christmas For Kids at Gethsemane? *
Do you currently have a church home *
I would like to learn more about Gethsemane Lutheran Church *
I would like to learn more about Gethsemane Lutheran School *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms