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UUCPA CYRE Registration
2019 - 2020 Registration Form for Children and Youth Programs for the Unitarian Universalist Church of Palo Alto.
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* Indicates required question
Child 1 Last name
*
Your answer
Child 1 First name
*
Your answer
Child 1 Grade
*
Your answer
Child 1 Birth date
*
MM
/
DD
/
YYYY
Child 2 Last name
Your answer
Child 2 First name
Your answer
Child 2 Grade
Your answer
Child 2 Birth date
MM
/
DD
/
YYYY
Child 3 Last name
Your answer
Child 3 First name
Your answer
Child 3 Grade
Your answer
Child 3 Birth date
MM
/
DD
/
YYYY
Child 4 Last name
Your answer
Child 4 First name
Your answer
Child 4 Grade
Your answer
Child 4 Birth date
MM
/
DD
/
YYYY
Any special info about any children (allergies, etc.) we need to know?
Your answer
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