DUUF Nursery and Explorers Registration Form

Please complete a separate form for each child.

Child Information

Name

*

Pronouns

Birthdate

*

Grade

*

Please select one option.

No Grade Pre-Kindergarten Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Graduated

RE Program

*

Please select one option.

Nursery Explorers pre-K to 5th grade

Parent/Guardian Information

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

Additional Information

Please share any information we need to know about your child, including allergies, medications, dietary needs, etc. You may want to include special needs, family dynamics, or anything else that would help us better support your child.

Allergies

Medical Conditions

Medications

Other Information

Emergency Contact Information

Name (Emergency contact 1)

Cell phone (Emergency contact 1)

Home phone (Emergency contact 1)

Name (Emergency contact 2)

Cell phone (Emergency contact 2)

Home phone (Emergency contact 2)

Photo Release

I give permission for my child's photo to be featured on:

Photo Release

Please select all that apply.

Bulletin boards at DUUF DUUF website Social Media (public DUUF page and closed DUUF community group)

Description

Please complete a separate form for each child.

Please Fix the Following

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