Child Information Form
As we update our database, please complete the following about your child/youth. This important information is to help our ministry leaders connect with your kids and for church use only. Thanks for helping us!

***IF YOU HAVE MULTIPLE CHILDREN, PLEASE SCROLL DOWN TO COMPLETE A SECTION FOR EACH ONE.
Sign in to Google to save your progress. Learn more
Child #1 Name *
Child #1 Birth Date *
MM
/
DD
/
YYYY
Child #1 Gender *
Child #1 Grade (2021-22 School Year) *
Child #1 School *
Child #1 Email (xxx if not one) *
Child #1 Cell Number (xxx if not one) *
Child #1 Texts?
Clear selection
Family Address (Street, City, Zip Code) *
Mother's Name *
Mother's Cell Number *
Mother's Email *
Mother's Date of Birth *
MM
/
DD
/
YYYY
Father's Name *
Father's Cell Number *
Father's Email *
Father's Date of Birth *
MM
/
DD
/
YYYY
Parents Are.... *
IF YOU HAVE ONLY 1 CHILD - CLICK "NEXT" to move through the following sections to get to the "SUBMIT" button. TO ADD MORE CHILDREN - please complete each section needed and then click "SUBMIT". Thank you!
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Jarvis Memorial United Methodist Church. Report Abuse