Youth and Children’s Religious Education Registration Form

 

    Caregiver (Primary)*

    Is this an emergency contact?

    Caregiver (Secondary)

    Is this an emergency contact?

    Is this an emergency contact?

    Child/ Youth Information

    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:

    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:


    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:


    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:


    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:


    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:


    Birthday Date*
    Pronouns*
    School
    Anticipated attendance:

    Caregiver Religious Education Support*

    UUCA’s Religious Education (RE) program is a cooperative program that relies on the time and talents of many of caregivers like yourself. Please indicate how you would like to support your child’s program.
    Check all that apply:
    Photo and Video Release*
    X