RE Registration 2022-23

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Child #1 name *

Child #1 GRADE in school (or approx.equivalent if home-schooled) *

Child #1 DOB *

YYYY

Child#1 allergies or considerations *

Child #2 name *

Child #2 GRADE in school (or approx.equivalent if home-schooled) *

Child #2 DOB *

YYYY

Child #2 Allergies or considerations *

Child # 3 Child #4 and up please list together

Child #3, #4, and up please list names plus grades

Child #3, #4, and up please list name plus DOB

Child # 3. #4, and up -please list name plus allergies and considerations .

Parent(s)/guardians name(s) *

parent(s) guardian email *

Parent(s)/guardian address and phone *

I give permission for UUCW to use images on our website and social media - no full names used *

yes

I understand that UUCW RE program is run as a cooperative where parents and guardians assist throughout the year. Usually it is no more than 3 times. We also need adults who are willing to be a lead teacher for a short block (up to 6 times) or run a special program. Please let us know where you can help. Thank you!! *

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