JFC Children's Ministry Registration Form
Jackson Friends Church Children's Program
Parent/Legal Guardian First Name
Your answer
Parent/Legal Guardian Last Name
Your answer
Relationship to Child(ren)
Your answer
Mailing Address
Your answer
City
Your answer
Zip Code
Your answer
Email Address
Your answer
Phone Number
Home or Cell
Your answer
In the event of an emergency, I authorize first aid or medical treatment for each child named below, and I release Jackson Friends Church from any and all responsibility in connection therewith.
Required
#1 - Child's First Name
Your answer
#1 -Child's Last Name
Your answer
#1-Child's Birthdate
MM
/
DD
/
YYYY
#1- Grade
Your answer
#1 - Special Instructions/Allergies
Your answer
#2 - Child's First Name
Your answer
#2 -Child's Last Name
Your answer
#2 -Child's Birthdate
MM
/
DD
/
YYYY
#2 - Grade
Your answer
#2 - Special Instructions/Allergies
Your answer
#3 - Child's First Name
Your answer
#3 -Child's Last Name
Your answer
#3 -Child's Birthdate
MM
/
DD
/
YYYY
#3 - Grade
Your answer
#3 - Special Instructions/Allergies
Your answer
#4 - Child's First Name
Your answer
#4-Child's Last Name
Your answer
#4 -Child's Birthdate
MM
/
DD
/
YYYY
#4 - Grade
Your answer
#4 - Special Instructions/Allergies
Your answer
#5 - Child's First Name
Your answer
#5-Child's Last Name
Your answer
#5 -Child's Birthdate
MM
/
DD
/
YYYY
#5 - Grade
Your answer
#5 - Special Instructions/Allergies
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Jackson Friends Church. Report Abuse - Terms of Service - Additional Terms