UPUCC Children's Registration 2023-24

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Thank you for helping to keep our records up to date! Please fill out one form for each child. If you have any questions or comments, you are welcome to reach out to tyler@upucc.org

All information is confidential. Though we will share this information with our Teachers and Assistants, it will not be given out to anyone else without your written permission.

Child's First Name *

Child's Last Name *

Date of Birth *

YYYY

Grade level for the 2023-24 academic year: *

Pre-K

Kindergarten

N/A

Pronouns *

He / Him

She / Her

They / Them

Prefer not to answer

Other:

Any allergies, accessibility, or health needs that would be helpful to know?

Does UPUCC have permission to use photos of your child? (By default, we will not use photos unless permission is given) *

Yes

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