Newman Congregational Church,UCC 2017-18 Church School Registration
If you are registering multiple children, please complete a form for each child.
*
Child's Name *
Your answer
Preferred Nickname
Your answer
Birthday *
MM
/
DD
/
YYYY
Home Address *
Your answer
Home Phone *
Your answer
Grade (as of Sept. 2017) *
Your answer
School
Your answer
Allergies/Medical Concerns *
Your answer
Interests & Learning Strengths *
Your answer
Any Learning/Social/Emotional Challenges? *
Required
If you answered yes above, please share any information that might help us provide the best experience and support your child.
Your answer
I give permission for my child’s picture (without name) to be used on Newman Congregational Church, UCC’s website, Facebook page, and in other publications *
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