[your-subject "BRUU Religious Education"]
Parent/Guardian Name*
Address*
Preferred Phone*
Alternate Phone
Email*
Preferred Communication Method: emailtext
This is the Child(ren)'s Primary Address:YesNo
Parent/Guardian Name
Address
Preferred Phone
Email
A copy of the Court Order is required to be on file with DRE to enforce.
Name1
Relation1
Name2
Relation2
First Name
Last Name
Preferred Name
Birthdate
Grade as of Sept 2021
Special Needs: Health/Diet
Anything we need to know?
Schedule a private appointment with the DRE to discuss?Yes
May we have permission to use photographs/videos of your child(ren) for the purpose of public relations and general publicity for BRUU? Children will NOT be identified by name. YesNo
By submitting this form, I understand that there are risks associated by voluntary participation. I agree to hold harmless Bull Run Unitarian Universalists, its staff, volunteers, and representatives from outcomes that may result by participation.
If medical attention is needed during participation, I consent to BRUU’s representatives to provide care and make decisions in my absence. I agree to be financially responsible for any costs related to that treatment.
