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UNITED @ SJC Registration 2022-2023
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Student Name
Your answer
Grade Level 2022-2023
Choose
4th
5th
6th
7th
8th
Birthday (Month & Day)
Your answer
Student #2 Name (optional--for siblings)
Your answer
Student #2 Grade Level 2022-2023
Choose
4th
5th
6th
7th
8th
Student #2 Birthday (Month & Day)
Your answer
Student #3 Name (optional--for siblings)
Your answer
Student #2 Grade Level 2022-2023
Choose
4th
5th
6th
7th
8th
Student #3 Birthday (Month & Day)
Your answer
Parent/Guardian #1 Name
Your answer
Parent/Guardian #1 Email
Your answer
Parent/Guardian #1 Cell Phone
Your answer
Parent/Guardian #2 Name (optional)
Your answer
Parent/Guardian #2 Email (optional)
Your answer
Parent/Guardian #2 Cell Phone (optional)
Your answer
Home Address
Your answer
Other important information? (allergies, dietary restrictions, special needs, etc.)
Your answer
May we use photos including your child(ren) on our church and student social media accounts?
Yes
No
Clear selection
Are you willing to serve on a parent team to sponsor and serve one or two UNITED dinners this year (no commitment at this point, just interest)?
Yes
No
Maybe; I'd like more information
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