JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Emergency Contact Information
Atlanta Friends Meeting wants to have on file an emergency contact for regular attenders and members, in case you have an emergency at the meetinghouse. This information will be accessible by the Care & Counsel committee and the meeting staff only.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Today's Date (to move between the parts of the date, select the next part with your mouse or finger OR hit the tab key)
*
MM
/
DD
/
YYYY
Your Name
*
Your answer
Your pronouns
*
She/her/hers
He/him/his
They/them/theirs
Other:
Emergency contact's name
*
Your answer
My emergency contact is:
*
My partner or spouse
My parent(s)
My child(ren)
Friend
Other:
Phone number(s) for emergency contact
*
Include both home and cell numbers, please, if applicable
Your answer
Email address
Your answer
What is the best way to reach this person? Call (and which number)? Text? Email?
*
Your answer
Special instructions
Your answer
Do you want to add a second emergency contact?
*
This allows you to have a second emergency contact on file, in case you have an emergency at the meetinghouse and the first person can not be reached.
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
