UBY Youth Program - Registration Form
One form must be completed by the parent or legal guardian for each child being registered.
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Full Name of Parent / Legal Guardian: *
Address *
Email: *
Cell Phone (in case of emergency): *
How would you like us to notify you of upcoming UBY events? Select all that apply. *
Required
Child's Name: *
Child's Birth Date: *
MM
/
DD
/
YYYY
Child's Current Grade: *
Any allergies or sensitivities? *
Any medical conditions or special needs? *
Anything else we should know about your child?
Transportation may be available upon request, but is not guarenteed. Would your child need transportation?
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