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RE Registration Form 2022-2023
For safety and administrative reasons, the Religious Education Committee asks that you complete this registration form. Only one form is needed per family. Please complete and submit online. If you prefer to hand-write the form, a printable form is available on the USH website, or you can find it at the Welcome Table. Just complete the form and return to our RE associate, Annie Witzler, our office administrator, Buffy Pinney, or mail your completed form to The Unitarian Society of Hartford, 50 Bloomfield Ave, Hartford, CT, 06105.

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Date: *
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Parent/Guardian #1 - Last Name *
First Name *
Address (street name with apartment number if applicable) *
City *
Zip Code *
Primary Phone Number (please indicate if it is a home, mobile, or work number) *
Secondary Phone Number (please indicate if it is a home, mobile, or work number) *
Email Address (please include an email you frequently check for updates on our RE events!) *
Parent/Guardian #2 - Last Name.
First Name
Address (street name with apartment number if applicable) *
City
Zip Code
Primary Phone Number (please indicate if it is a home, mobile, or work number)
Secondary Phone Number (please indicate if it is a home, mobile, or work number)
Email Address (please include an email you frequently check for updates on our RE events!)
Children live with: *
Child #1 - Last name. *
First Name (feel free to include nicknames and/or preferred names!) *
My child's preferred pronouns are:
Birthdate: *
MM
/
DD
/
YYYY
Age today: *
Grade level as of August, 2022. *
Name of school district or private school (if homeschooled, please indicate.) This helps us plan our RE calendar. *
When it comes to expressing themselves, my child prefers to... *
Required
My child's interests include, but are not limited to: (Note - some interest areas will overlap, this is intentional). *
Required
In this box, please add anything you want our RE supervisor to know about, i.e., allergies, need for mobility assistance, developmental issues, gender identity, or any other personal concerns. This helps us to better meet the needs of your child. If you would prefer to share this information in person, please indicate and our associate of religious education will be in touch. *
Child #2 - Last name.
First Name (feel free to include nicknames and/or preferred names!)
My child's pronouns are:
Birthdate:
MM
/
DD
/
YYYY
Age today:
Grade level as of August, 2022.
Name of school district or private school (if homeschooled, please indicate.) This helps us plan our RE calendar.
When it comes to expressing themselves, my child prefers to...
My child's interests include, but are not limited to: (Note - some interest areas will overlap, this is intentional).
In this box, please add anything you want our RE supervisor to know about, i.e., allergies, need for mobility assistance, developmental issues, gender identity, or any other personal concerns. This helps us to better meet the needs of your child. If you would prefer to share this information in person, please indicate and our associate of religious education will be in touch.
Child #3 - Last name.
First Name (feel free to include nicknames and/or preferred names!)
My child's pronouns are:
Birthdate:
MM
/
DD
/
YYYY
Age today:
Grade level as of August, 2022.
Name of school district or private school (if homeschooled, please indicate.) This helps us plan our RE calendar.
When it comes to expressing themselves, my child prefers to...
My child's interests include, but are not limited to: (Note - some interest areas will overlap, this is intentional).
In this box, please add anything you want our RE supervisor to know about, i.e., allergies, need for mobility assistance, developmental issues, gender identity, or any other personal concerns. This helps us to better meet the needs of your child. If you would prefer to share this information in person, please indicate and our associate of religious education will be in touch.
Child #4 - Last name.
First Name (feel free to include nicknames and/or preferred names!)
My child's pronouns are:
Birthdate:
MM
/
DD
/
YYYY
Age today:
Grade level as of August, 2022.
Name of school district or private school (if homeschooled, please indicate.) This helps us plan our RE calendar.
When it comes to expressing themselves, my child prefers to...
My child's interests include, but are not limited to: (Note - some interest areas will overlap, this is intentional).
In this box, please add anything you want our RE supervisor to know about, i.e., allergies, need for mobility assistance, developmental issues, gender identity, or any other personal concerns. This helps us to better meet the needs of your child. If you would prefer to share this information in person, please indicate and our associate of religious education will be in touch.
PHOTO PERMISSION: Please check the YES box if you give the Religious Education Program permission to use your child(ren)'s photographs in various publications created by and for USH. Please note: We will not include the names of children with photos. *
RE Volunteers wanted! Please consider volunteering in our RE classroom or for a one-time event. *
Required
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