Unitarian Universalist Church of Buffalo Religious Education Registration 2016-2017
Thank you so much for registering your child in the Religious Education program at the Unitarian Universalist Church of Buffalo. We ask that all children who intend to regularly attend a Religious Education class, nursery through High School Youth Group, submit a completed registration form. Visitor forms are available at the Religious Education table for occasional drop-ins and first time visitors. Please complete the entire form. We appreciate your participation in our RE program! We couldn't do it without YOU.
Child # 1 Name
Your answer
Child #1 Date of Birth
Your answer
Child #1 School Grade
Your answer
Child #2 Name
Your answer
Child #2 Date of Birth
Your answer
Child #2 School Grade
Your answer
Child #3 Name
Your answer
Child #3 Date of Birth
Your answer
Child #3 School Grade
Your answer
Child #4 Name
Your answer
Child #4 Date of Birth
Your answer
Child #4 School Grade
Your answer
Parent/Caregiver #1, Home Address, Phone Number & Email
Your answer
Parent/Caregiver #2, Home Address, Phone Number & Email
Your answer
Which email address(es) would be best for you to receive our weekly Religious Education email updates?
Your answer
Emergency Contact (Name and Phone Number)
Your answer
Medical Information (Insurance Policy # and Primary Care Physician Name and Phone Number)
Your answer
Special Concerns
Please be sure to indicate if an allergy is life threatening, and give details of how/when you wish to be contacted if an issue arises. Any information you can give us to help us better serve your child is welcome!
Does your child have any allergies?
Your answer
Does your child have any dietary restrictions?
Your answer
Does your child have developmental needs? And if applicable, what works best to calm/engage your child?
Your answer
Does your child have any medical conditions?
Your answer
Are there any other questions or concerns you have for us?
Your answer
Photo/Media Release Permission
Please complete the following questions in order to insure that your child's image is not used without your permission. We never identify any of the children used in photographs on the website, facebook page, weekly email, or other electronic or in house materials.
May we use your child's picture on church bulletin boards?
Required
May we use your child's picture for semi-private electronic correspondence? (Such as the "closed" Religious Education Facebook group.)
Required
May we use your child's picture in other church related internet correspondence? (Such as the weekly Religious Education email, the public church Facebook page, the church website, or YouTube videos of church events.)
Required
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