Religious Education Registration
South Nassau Unitarian Universalist Congregation
228 South Ocean Avenue, Freeport, N.Y.
516-623-1204 ~ www.snuuc.org
Please complete a separate registration for each child
Child's last name
Your answer
Child's first name
Your answer
Child's preferred name
Your answer
Grade as of September 2016
Your answer
Age and Birthdate
Your answer
Address
Your answer
Parent / Guardian #1 Name
Your answer
Address
Your answer
Telephone # (home)
Your answer
Telephone # (cell)
Your answer
E-Mail
Your answer
Parent / Guardian #2 Name
Your answer
Address
Your answer
Telephone # (home)
Your answer
Telephone # (cell)
Your answer
Please share any special needs we should know about your child:
If there is anything you would like us to know either now, or later about your child please call or speak to Harriet Arnold.

I will designate a guardian for my child if I cannot be in the building with my child during services. I understand that my child will be released to share coffee hour at 11:45 a.m.

I/we understand that volunteers are necessary to make the Religious Education program effective. Each parent / guardian is requested to volunteer for 2 hours a month. (There will be months you won’t need to) I am/we are volunteering for one or more of the following. Please check one or more of the following or indicate others ways in which you’d like to contribute.
Name of person completing form
Your answer
Today's date
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