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Parent or Guardian
First Name
Last Name
Ethnicity
*
American Indian or Alaska Native.
Asian.
Black or African American.
Hispanic or Latino.
Native Hawaiian or Other Pacific Islander.
White.
Wish not to answer
Gender
Male
Female
Age Group
*
16-21
21-34
35-59
60+
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Phone Number
-
Area Code
Phone Number
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E-mail
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Which County you Live in?
*
Adams County, OH
Allen County, OH
Ashland County, OH
Ashtabula County, OH
Athens County, OH
Auglaize County, OH
Belmont County, OH
Brown County, OH
Butler County, OH
Carroll County, OH
Champaign County, OH
Clark County, OH
Clermont County, OH
Clinton County, OH
Columbiana County, OH
Coshocton County, OH
Crawford County, OH
Cuyahoga County, OH
Darke County, OH
Defiance County, OH
Delaware County, OH
Erie County, OH
Fairfield County, OH
Fayette County, OH
Franklin County, OH
Fulton County, OH
Gallia County, OH
Geauga County, OH
Greene County, OH
Guernsey County, OH
Hamilton County, OH
Hancock County, OH
Hardin County, OH
Harrison County, OH
Henry County, OH
Highland County, OH
Hocking County, OH
Holmes County, OH
Huron County, OH
Jackson County, OH
Jefferson County, OH
Knox County, OH
Lake County, OH
Lawrence County, OH
Licking County, OH
Logan County, OH
Lorain County, OH
Lucas County, OH
Madison County, OH
Mahoning County, OH
Marion County, OH
Medina County, OH
Meigs County, OH
Mercer County, OH
Miami County, OH
Monroe County, OH
Montgomery County, OH
Morgan County, OH
Morrow County, OH
Muskingum County, OH
Noble County, OH
Ottawa County, OH
Paulding County, OH
Perry County, OH
Pickaway County, OH
Pike County, OH
Portage County, OH
Preble County, OH
Putnam County, OH
Richland County, OH
Ross County, OH
Sandusky County, OH
Scioto County, OH
Seneca County, OH
Shelby County, OH
Stark County, OH
Summit County, OH
Trumbull County, OH
Tuscarawas County, OH
Union County, OH
Van Wert County, OH
Vinton County, OH
Warren County, OH
Washington County, OH
Wayne County, OH
Williams County, OH
Wood County, OH
Wyandot County, OH
ZipCode
*
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Attendance
Numbers of Kids Attending
Please Select
1
2
3
4
5
6
7
8
9
10
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Reserve only for Children 9 and Up
*
Girl's Circle
Boy's Council
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Children Attending
*
Child Full Name
Child Age
Pick Program
Any thoughts?
1
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
2
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
3
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
4
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
5
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
6
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
7
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
8
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
9
9
10
11
12
13
14
15
16
17
Girl's Circle
Boy's Council
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Comments
Please Enter any questions or concerns that you dont see listed on the form
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Do you want to be contacted about other programs? If so choose the ones that apply
*
Adopt a Family (Holiday, Easter, Thanksgiving and Christmas)
Joy For Kids this Christmas (Program Runs from October till December20)
Cribs for Kids (All Year Round)
Back 2 School (Program runs From June till August)
Mom Fathers & Babies
Adult & Literacy
Hot Meals
Summer Camp
Youth Minds
Other
Who refer you:
*
God's Vision Foundation
Lorettas Helping Hands
Passionate House of Change
STR8POSITIVE
Friend a Felon
Social Media ( Facebook, Instagram, Twitter
Refer by a Friend
Refer by another Organization
Search Engine
Other
Would you like to become a volunteer with God's Vision Foundation?
*
Yes
No
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SUBMIT
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Candidate Declaration - Please sign to declare that the information you have given is true and correct, that you agree to GODS VISION FOUNDATION on the terms and conditions set out in this registration. The undersigned grant permission to God's Vision Foundation, Corp and its partners for the use of the photograph(s) or electronic media images taken at GVF events, This does not include documents uploaded in this form, GVF will have ownership of all photograph(s) or electronic media images taken at GVF events, as identified below in any presentation of any and all kind whatsoever. Images can be use for Social Media, Website or any promotions of all king for God's Vision foundation, Corp. Images will be stored in a secure location and only authorized staff will have access to them. They will be kept as long as they are relevant and after that time destroyed or archived.
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