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Registration for PBUUC Religious Exploration
PBUUC Safety Policy requires your child's registration
All Children Ages 0-18 must be registered to attend class
Child's First Name
Your answer
Child's Last Name
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Birthdate
MM
/
DD
/
YYYY
Age as of September, 2016
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Grade in September, 2016
Your answer
Full Address: street, city, state and zip code
Your answer
Does your child have any allergies?
If yes, please describe allergies and how you would like us to handle these.
Your answer
Does your child have any special needs that the teachers should be aware of?
If your child has special needs, describe briefly below and please speak to the DMRE so that we may best serve your child.
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