Family Registration Form Religious Education for Children & Youth, Emerson Unitarian Universalist Church
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.
Date submitted: *
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Parent/Guardian #1 - Last Name *
Your answer
Parent/Guardian #1 - First Name *
Your answer
Parent/Guardian #1 - Street Address *
Your answer
Parent/Guardian #1 - City *
Your answer
Parent/Guardian #1 - Zip Code *
Your answer
Parent/Guardian #1 - Home Phone *
Your answer
Parent/Guardian #1 - Cell Phone *
Your answer
Parent/Guardian #1 - Work Phone
Your answer
Parent/Guardian #1 - Email *
Your answer
Parent/Guardian #2 - Last Name
Your answer
Parent/Guardian #2 - First Name
Your answer
Parent/Guardian #2 - Street Address
Your answer
Parent/Guardian #2 - Home Phone
Your answer
Parent/Guardian #2 - Zip Code
Your answer
Parent/Guardian #2 - City
Your answer
Parent/Guardian #2 - Work Phone
Your answer
Parent/Guardian #2 - Cell Phone
Your answer
Parent/Guardian #2 - Email
Your answer
How would you like to support our Religious Education Program this year? *
Our Religious Education program serves over one hundred children and youth and we have just one paid staff member--volunteers make it all work! Please indicate which volunteer opportunities appeal to you.
Required
Children live with: *
Child #1 - First Name *
Your answer
Child #1 - Birthdate *
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Child #1 - Last Name *
Your answer
Child #1 - Age today *
Your answer
Child #1 - Grade as of September 1, 2017 *
Your answer
Child #1 - Name of school district or private school (if homeschooled, please indicate.)
This helps us plan our Sunday School calendar.
Your answer
Child #2 - Last Name
Your answer
Child #2 - First Name
Your answer
Child #2 - Birthdate
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DD
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YYYY
Child #2 - Age today
Your answer
Child #2 - Grade as of September 1, 2017
Your answer
Child #2 - Name of School District or Private School (if homeschooled, please indicate.)
This helps us plan our Sunday School calendar.
Your answer
Child #3 - Last Name
Your answer
Child #3 - First Name
Your answer
Child #3 - Birthdate
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DD
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YYYY
Name of public school district or private school (if homeschooled, please indicate.)
This helps us plan our Sunday School calendar.
Your answer
Child #3 - Age today
Your answer
Child #3 - Grade as of September 1, 2017
Your answer
Child #4 - Last Name
Your answer
Child #4 - First Name
Your answer
Child #4 - Birthdate
MM
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DD
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YYYY
Child #4 - Age today
Your answer
Child #4 - Grade as of September 1, 2017
Your answer
Additional Information
In this box, please add anything you want our Sunday school director to know about, i.e., allergies, developmental issues, gender identity, or any other personal concerns. This helps us to better meet the needs of your child(ren). If you would prefer to share this information in person, please indicate and our director of religious education will be in touch.
Your answer
Child #4 - Name of School District of Private School (if homeschooled, please indicate.)
This helps us plan our Sunday School calendar.
Your answer
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 Emerson Unitarian Universalist Church. Please note: We will not include names of children with photos.
If yours is a two-adult family, please let us know which adult (or both) is/are volunteering above.
Your answer
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