Children's Religious Education Registration
Child's Name *
Your answer
Sex *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
Parent/Guardian *
Your answer
Phone Number *
Your answer
Email *
Your answer
Parent/Guardian
Your answer
Phone Number
Your answer
Email
Your answer
Child's Physician
Your answer
Phone Number
Your answer
Allergies *
Your answer
Special Needs/Restrictions *
Your answer
Medication(s) *
Your answer
Emergency Contact/Relation to Child *
Your answer
Phone Number *
Your answer
Photo Release: I give my child Permission to be photographed and/or videotaped at UUCT events. I understand that these photos may be published in public venues such as the UUCT newsletter, UUCT website, and social media such as YouTube or Facebook. *
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