Religious Education Program Registration 2019-2020
Welcome to the Unitarian Universalist Church of Buffalo! Thank you for registering your children and youth in our program! Registration gives us vital information and ensures that we can best meet the needs of our child in our classrooms. It also contributes to increased accountability for our program. We are so glad you're here and we look forward to serving your family this year!
Child #1 Name *
Your answer
Child #1 Date of Birth *
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Child #1 School Grade/Homeschool
Your answer
Child #1 Allergy and Special Needs Information *
Your answer
Child #2 Name
Your answer
Child #2 Date of Birth
MM
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DD
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YYYY
Child #2 School Grade/Homeschool
Your answer
Child #2 Allergy and Special Needs Information
Your answer
Child #3 Name
Your answer
Child #3 Date of Birth
MM
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DD
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YYYY
Child #3 School Grade/Homeschool
Your answer
Child #3 Allergy and Special Needs Information
Your answer
Child #4 Name
Your answer
Child #4 Date of Birth
MM
/
DD
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YYYY
Child #4 School Grade/Homeschool
Your answer
Child #4 Allergy and Special Needs Information
Your answer
Parent/Caregiver #1 Name *
Your answer
Parent/Caregiver #1 Phone *
Your answer
Parent/Caregiver #1 Email *
Your answer
Parent/Caregiver #1 Home Address *
Your answer
Parent/Caregiver #2 Name
Your answer
Parent/Caregiver #2 Phone
Your answer
Parent/Caregiver #2 Email
Your answer
Parent/Caregiver #2 Home Address
Your answer
Emergency Contact Information (Name, Phone, Email, Relationship) *
Your answer
Is there any additional information about your child that can help us serve your family?
Your answer
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