Children's Religious Education Registration
Child's Name *
Sex *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Parent/Guardian *
Phone Number *
Email *
Parent/Guardian
Phone Number
Email
Child's Physician
Phone Number
Allergies *
Special Needs/Restrictions *
Medication(s) *
Emergency Contact/Relation to Child *
Phone Number *
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. *
Submit
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