How do I upload a Word document to become an Emergency Form on your site?

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    Asked on February 24, 2014 at 03:46 PM

    Hello, we've sent a couple emails back and forth with you guys and I don't think I was explaining what I really wanted done. The Child Emergency Contact Form that we have on this site was one that we created from one of your templates. We would like to use our own. And I have the word document and/or also in pdf form that I would like to use. Could you please email and call me to explain how I can do this? 310-867-3522.

    Below is a copied and pasted form of the document i would like to upload...










    CHOOSE A PROGRAM:    __ AFTER SCHOOL: __________________________    __ SUMMER CAMP




    Child’s Name: ________________________________  Birthdate: _____/_____/______     Upcoming grade: _______




    Address: ________________________________ City: ____________________ Zip: ______________


    HOW DID YOU HEAR ABOUT US? _______________________Referred By: ____________________




     SHIRT SIZE: YOUTH S (6-8) ____ M (10-12) ___ L (12-14) ___     ADULT  S ____ M ____ L____ XL____ 2x ___







    GUARDIAN #1:    





                      Name: __________________________________   Drivers License #:______________________


    Home #: ______________________Cell #: ______________________ Work#: ______________________


    Email: ________________________  Employment: _____________________ Position: _______________





    GUARDIAN #2:    





                      Name: ___________________________________  Drivers License #:_____________________


    Home #: ______________________Cell #: _______________________ Work#: _____________________


    Email: ________________________  Employment: _____________________ Position: _______________













    Name: _________________­­­__________    Relationship: _________________ Phone: ________________


    Name: ___________________________    Relationship: _________________ Phone: ________________


    Name: ___________________________    Relationship: _________________ Phone: ________________












    Name: _________________­­­__________    Relationship: _________________ Phone: ________________


    Name: ___________________________    Relationship: _________________ Phone: ________________


    Name: _________________­­­__________    Relationship: _________________ Phone: ________________


    Name: ___________________________    Relationship: _________________ Phone: ________________



    Release of Liability






    I hereby release and hold harmless College Bound for Kids, its agents, employees, officers, directors, sponsoring groups and/or agencies from any and all liability which may result from my child’s participation in the program.  I understand that payments are due in full on the 1st of the month or by the 1st day of each week, and I have seen the payment schedule for late payments.  I am also aware of the $40 additional fee for any returned checks.  If my child cannot conform to the structure of the program, I will be asked to remove him/her from the program and will not be issued a refund. College Bound for Kids has a NO REFUND POLICY; there will be no exceptions.  We do not give credit or make-up days for your child’s absence. Parents are responsible for the entire monthly/weekly fees regardless of holidays, absences, vacations or payments made by third parties. CBFK is not responsible for lost or stolen items.






    Occasionally College Bound for Kids uses group/individual photos of students for the purpose of advertisement, display or educational purposes.  Please initial at the end of this sentence if you do not authorize CBFK to use your child in a group/individual photo.__






    CBFK staff has permission to take whatever steps they deem appropriate to obtain medical care for our child in the event of illness, accident, or injury.  In this connection, we understand that they will attempt to contact us and that, if they find it necessary, they will call the child’s doctor, or another doctor, call an ambulance, or have our child taken to a hospital in the company of a staff member, as they deem appropriate.  We, the parents/guardians agree to be responsible for any expenses incurred in obtaining such medical care, and we hereby release College Bound for Kids from all liability in connection with their actions pursuant to authorization. I hereby acknowledge the existence of the assigned risk associated with all programs for children and the areas where such activities and programs take place.




    List any specific health concerns your child may have (illness, allergies, sensitivities, etc…) __________________________________________


    Does your child have any special needs? (Please specify) _________________________________________________________________




    Insurance Co: ____________________  Physician/Phone#:_______________________  Policy#: ____________________




    Your signature below indicates that you have read and understand all the policies and information for College Bound for Kids and adhere to the terms of the program.




    ______________________________________       ______________  

    Signature of Parent/Guardian                                                                                 

  • Profile Image
    Answered on February 24, 2014 at 04:15 PM

    Hi,  this would not be possible, since it is just plain text. Our form builder is very easy to use, it´s all a matter of drag and drop the fields.

    You can add the Heading and Sub Heading:

    Yo can use the Radio Button field for "Choose a program":

    We have more fields for you to get the contact informaiton for each people under Quick Tools:

    For the policie documents you could use our Scroll Terms widget, or 

    You can even have submitters to sign the form with our E-signature, or Smooth Signature widgets. You can start building you form, as I said there are a lot of features you can use to accomplish what you want in a matter of minutes jut by dragging and dropping fields. If you need help, let us know, we will be glad to assist you.