Children and Youth Religious Education Registration
Welcome to the Children and Youth Religious Education program at the Unitarian Universalist Church of Little Rock!

“The great end in religious instruction, is not to stamp our minds upon the young, but to stir up their own; not to make them see with our eyes, but to look inquiringly and steadily with their own; not to give them a definite amount of knowledge, but to inspire a fervent love of truth; not to form an outward regularity, but to touch inward springs; not to bind them by ineradicable prejudices to our particular sect or peculiar notions, but to prepare them for impartial, conscientious judging of whatever subjects may be offered to their decision; not to burden memory, but to quicken and strengthen the power of thought.” ~William Ellery Channing, Unitarian Minister

Child's First and Last Name
Please include the child's legal name and preferred name.
Your answer
Child's Current Age
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Current Grade in School
Your answer
Child's Pronoun
Ex. Her/She, Him/He, They
Your answer
Does your child have any medical or behavioral concerns?
In order to help us meet your child's needs, please list any special needs, learning differences, sensitivities, etc.
Your answer
Does your child have any food allergies or sensitivities?
Please list each allergy/sensitivity and the severity.
Your answer
Parent/Guardian Name(s)
Your answer
Mailing Address
Your answer
Phone Number(s)
Your answer
Email Address #1
Your answer
Email Address #2
Your answer
Do any other parents share custody of this child?
If yes, please provide their name, phone number, and email.
Your answer
Photo/Video Release
Photographs and/or videos of my child(ren) may be posted on the UUCLR website, bulletin boards, and Facebook page from time to time (no names attached).
Authorization and Release
By typing my name below as an electronic signature, I hereby grant permission and medical release for my child or ward named above to participate in activities sponsored by the Unitarian Universalist Church of Little Rock (UUCLR). I release UUCLR and all volunteers and employees of UUCLR from any claim I or my child shall have arising out of any sponsored activity of UUCLR. I recognize that this permission and release is valid until revoked in writing and delivered to the office of UUCLR.
Your answer
Our RE program at UUCLR is cooperative. At least one adult from each family must either join a classroom teaching team or choose a non-classroom volunteer role. Contact Rachel Finley (uudre.rachel at gmail.com) for more information and to arrange your cooperative contribution.
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