Child & Youth Information Form

Child/Youth information

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Emergency Contact *

First

Last

Emergency Contact Phone Number *

Child #1 *

First

Last

Child #2 *

First

Last

Child #4 *

First

Last

Child #1 Allergies/Medical Concerns *

Child #1 Interests *

Child #1 Permission *

Yes No

Child #2 Allergies/Medical Concerns *

Child #2 Interests *

Child #2 Permission *

Yes No

Child #3 Allergies/Medicla Concerns *

Child #3 Interests *

Child #3 Permission *

Yes No

Submit

Rincon Congregational United Church of Christ,
122 N Craycroft, Tucson AZ 85711
520.745.6237
Office Hours: 9-12 & 1-4 M-F Summer Hours Closed Fridays at Noon: June & July.
Office E-mail: office@rinconucc.org

Worship Sunday at 8:45 am & 10:45 am June 18 & 25
(with "Celebrate" for children & The Journey for "tweens" at 10:45 am)
Child care is available at both services.
July on service at 10 am in the Sanctuary
August one service at 10 am in the Fellowship Hall