Registration for UUR Religious Exploration for Families

Contact Information - Parent/Caregiver #1

Name of Parent/Caregiver #1

Email of Parent/Caregiver #1

This address will receive a confirmation email

Phone of Parent/Caregiver #1

Mailing Address

Physical Address

Contact Information - Parent/Caregiver #2

Name of Parent/Caregiver #2

Email of Parent/Caregiver #2

Phone of Parent/Caregiver #2

Mailing Address #2

Physical Address #2

Child #1

Name of Child #1

Birthdate of Child #1

Child #1 Gender Identity (male, female, non-binary, other -please specify

Child #1 Pronouns Used (she/her; he/his; they/them; other -please specify)

School Grade entering in the Fall of current school year?

Homeschooled? Yes No

Allergies, Medications or Challenges?

Child #2

Name of Child #2

Birthdate of Child #2

Child #2 Gender Identity (male, female, non-binary, other -please specify)

Child #2 Pronouns Used (she/her; he/him; they/them; other -please specify)

School Grade entering in the Fall of current school year?

Homeschooled? Yes No

Allergies, Medications or Challenges?

Child #3

Name of Child #3

Birthdate of Child #3

Child #3 Gender Identity (male, female, non-binary, other -please specify)

Child #3 Pronouns Used (she/her; he/him; they/them; other -please specify)

School Grade entering in the Fall of current school year?

Homeschooled? Yes No

Allergies, Medications, or Challenges?

If you need more spaces for more children, please contact mail@uurockland.org. Still hit save on this form.

Permissions

Do you give permission for photos of your children in UUR activities to be used in media, including our UUR newsletter, bulletin boards at UUR, our website, Facebook and other forms of social media? We will ask permission of the parent/caregiver if we are using the full name of your child in the photo/video.

Photo Permission Yes, by checking this box, I am giving permission to use photos of my children as described above. No, I do not give permission

In a medical emergency, all efforts will be made to reach a parent. If a parent or guardian cannot be reached, do you authorize the adult in charge to obtain emergency medical services for your child? *Note, all field trips and overnight events will need paper copies of permission slips and health forms. These will be provided at the time of the event.

Medical Permission Yes, by checking this box, I am giving permission for emergency medical help as described above. No, I do not give permission.

Membership

By being together in community, we learn best and love best. We hope you will consider becoming a member of the First Universalist Church in Rockland. However, this is not a requirement to be active in Religious Exploration programs. Our Members & Friends Directory is a listing of all adults, friends and members, with addresses and phone numbers. Hospitality Teams provide coffee and snacks on Sunday morning. They also serve as greeters and ushers. Each team provides this service 4-5 times per year. The entire family is encouraged to participate. Please check all that apply.

Are you interested in learning more about how you can become a member of this faith community? Please check all that apply. Yes, Contact Me Not at this time, but we would like to be active, so please add our contact information to the Members & Friends Directory Not at this time, but we would like to be more connected. Please add our family to a Hospitality Team Not at this time, but please add my email to the e-newsletter list to receive UUR news and upcoming events Not necessary, we are already members

Registration for UUR Religious Exploration for Families

Description

Please Fix the Following