[your-subject "BRUU Religious Education"]

 

FAMILY REGISTRATION 2021-2022
Parent/Guardian 1

Preferred Communication Method: emailtext

This is the Child(ren)'s Primary Address:YesNo

Parent/Guardian 2

Preferred Communication Method: emailtext

This is the Child(ren)'s Primary Address:YesNo

Parent/Guardian 3

Preferred Communication Method: emailtext

This is the Child(ren)'s Primary Address:YesNo

Parent/Guardian 4

Preferred Communication Method: emailtext

This is the Child(ren)'s Primary Address:YesNo

List Persons NOT permitted to pick up:

A copy of the Court Order is required to be on file with DRE to enforce.

Child #1

Child #2

Child #3

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.