2019-20 UU Essex's RE Registration
59 Main St., Essex, MA (978)768-3690 reuuessex@gmail.com

UU Essex offers a variety of RE classes for children and youth ages 2-18. If interested, please submit the following information below to register your child (or children) for one of our programs.

If you have any questions, please contact our Director of Religious Education, Allison Rosner, at reuuessex@gmail.com
Parent/Guardian Name(s) *
Your answer
Parent/Guardian Telephone *
Your answer
Address *
Your answer
Email *
Your answer
Please list the names of other adults allowed to pick up your child/children in your absence: *
Your answer
Children & Youth Information
In the sections below, please tell us about the child, or children, you are registering for the RE program.
Registration for Child/Youth 1
Name *
Your answer
Child's preferred pronouns
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Does child have any allergies or medical conditions we should be aware of? *
Your answer
Any special needs or concerns you would like to share regarding your child? *
Your answer
Would you like to register another child?
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy