UUCB Religious Education Registration 2018-2019
Please complete ONE form per family. You will have the opportunity to enter each child/youth within this form. We will follow up with an email for payment/scholarship information. Please contact Adrienne Summerlot dre@uubloomington.org if you have any questions. THANK YOU!!!
Child/Youth's Information
First Name *
Last Name *
Date of Birth *
Current School Grade as of August 2018 *
Register Child for *
Special Needs (Medical, Dietary, Cognitive, etc)
Photo Release *
Do you have additional children to register? *
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