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Religious Education 2022-2023
Please complete this form to register your child(ren) for Religious Education programming at West Shore Unitarian Universalist Church.
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Email
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Your email
Parent/Guardian #1 First and Last Name
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Your answer
Parent/Guardian #1 email
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Your answer
Parent/Guardian #1 Address (street, city, zip code)
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Your answer
Parent/Guardian #1 Phone number
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Your answer
The phone number above is a:
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cell phone
land line
Parent/Guardian #2 First and Last Name
Your answer
Parent/Guardian #2 email
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Parent/Guardian #2 address (street, city, zip)
Your answer
Parent/Guardian #2 phone
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The phone number above is a:
cell phone
land line
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My child(ren) live with
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Parent/guardian #1
Parent/guardian #2
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Other:
Emergency Contact
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Please include name and phone number
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Child #1 First and Last Name
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Your answer
Child #1 Grade (or homeschool equivalent)
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Your answer
Child #1 Date of birth
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Child #1 Allergies or special needs (if none, type N/A)
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Add another child?
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