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
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Birthday
MM
/
DD
/
YYYY
Home Address
Your answer
Home Phone
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Grade (as of Sept. 2017)
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School
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Allergies/Medical Concerns
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Interests & Learning Strengths
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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.
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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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