Children's Hour Registration Form
St. John's Kittanning Children's hour Fall 2024 Registration
Sign in to Google to save your progress. Learn more
Child's Full Name
 *
Child's Nickname ( if any )
 *
Home Address
 *
Child's Birthdate
 *
MM
/
DD
/
YYYY
Allergies/Medical Concerns
 *
Tell us anything else about your child that we should know
 *
Home Congregation
 *
Which day of the week will you likely be attending class?  ( You can switch back and forth also )
 *
Parent/Guardian 1
 *
Parent/Guardian 1 Phone
*
Parent Guardian 2
 *
Parent/Guardian 2 Phone
 *
Parent Email Address
 *
Grandparent/ Caregiver Name
 *
Grandparent/ Caregiver Phone
 *
Additional Emergency Contact Name
 *
Additional Emergency Contact Phone
 *
In case of emergency, and I cannot be reached, I give permission for St. John's or Children's Hour staff/volunteers to seek appropriate medical attention for my child
 *
Permit my child to be photographed for Children's Hour social media ( private page)
*
Submit
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

Google Forms