Northlake Children's Religious Education Registration Form, Sept. 2016 - June 2017
Welcome to the Children's Religious Education Program at Northlake Unitarian Universalist Church. We have an exciting year planned for our children and youth!

Nursery: Our nursery offers a fun environment for our youngest children (0 - 5 years old) to make new friends and play. Older nursery children can also choose the Chalice Children option, below.

Chalice Children for 3 - 6 year olds: We are offering the Chalice Children class for all 3 - 6 year olds who would enjoy a more structured class than the play-based nursery option. Chalice Children offers an exploration of our Unitarian Universalist faith, the strength of community, the wonder and awe that transcend everyday understanding, and life issues we all share. Chalice children has a staff teacher who is there most every Sunday and a rotating assistant volunteer teacher. This allows children to have the consistency of a regular teacher and also get to know other adults in the congregation.

Labyrinth Learning for Kindergarten - 5th graders: Labyrinth Learning is our workshop-rotation model for Sunday school. This format allows children and youth the flexibility of choosing the activity that they are most interested in to explore the day's topic. The activities are divided into an arts/crafts station, a movement/music/drama activity station, a discussion-based activity station, and a reading station. This year we will learn about our Unitarian Universalist principles and values, and the sources of wisdom from which we draw, using the monthly worship themes in our Sunday morning services. Early elementary children can choose between Labyrinth Learning and Chalice Children, depending on their needs and interest. The Labyrinth Learning class is taught by a rotating group of three volunteer teachers each week.

Youth Groups: Our middle school and senior high youth group will focus on community building and discussion to explore how we live our values in our daily lives. We will also offer occasional field trip activities to foster friendships and fun.

Regular attendance makes a real difference in your child's experience. It helps your child establish friendships and provides a sense of continuity for students and teachers alike.

Tuition: NUUC requests that families donate $40 per child or $80 per family on behalf of the RE program. When classes start in the fall, please bring a check payable to NUUC and include "RE Registration" in the memo line. (You can drop the check off in the church office or in the offering basket.) If this amount would be a hardship for your family, please donate as you are able. Tuition money is used to purchase books, materials, and supplies for the Children's Religious Education program.

Visitors: We welcome visitors to our RE program! Visitors are not asked to pay tuition, but we do request that you complete a registration form so that we have all the information we need to best serve your family.

Parent/Guardian Information
(Primary contact if more than one)
Parent or Guardian Name
(Last name, First name)
Your answer
Parent or Guardian Email
(preferred email for RE correspondence)
Your answer
Parent or Guardian preferred telephone number
Your answer
Parent or Guardian alternate telephone number
Your answer
Parent or Guardian Address
Street, City, and Zip
Your answer
Second Parent/Guardian Information, if applicable
Parent or Guardian Name (second contact)
(Last name, first name)
Your answer
Second Parent or Guardian Email
(enter only if you would like a second email address to receive RE communications)
Your answer
Second Parent or Guardian preferred telephone number
(enter only if you would like to receive calls to a second number)
Your answer
Second Parent or Guardian Address
Street, City, and Zip (enter only if you would like correspondence sent to second address)
Your answer
Authorizations and Emergency Contacts
Emergency contact (offsite)
Name, phone number, and relationship to child/youth
Your answer
Persons authorized to pick up your child from NUUC classes or events
Your answer
Please list anyone NOT authorized to have contact with your child or youth
Your answer
Publicity Permission
I am the parent/legal guardian of the below-named children, and I give my consent that any photographs, videotapes and/or motion picture media of my child, and/or audio recordings of his/her voice while participating in NUUC programs and activities, may be used by Northlake Unitarian Universalist Church in any publication, including television and website, promotional/marketing materials, educational materials and teacher/parent communication. Northlake Unitarian Universalist Church will not print the names of any pictured children on its website or Facebook page. This consent is effective immediately, and will stay in effect for five years.
Required
Consent to Medical Treatment and Care of Minor Children
I, the parent/legal guardian of the below-named children, hereby give my permission that my child/children may be given emergency treatment to include first aid and CPR while engaged in activities at Northlake Unitarian Universalist Church. I further authorize and consent to medical, surgical, and hospital care, treatment, and procedures to be performed for my child by my child's regular physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child's health. I waive my right of informed consent to such treatment. I also give permission for my child to be transported by ambulance or aid car to an emergency center for treatment. This consent is effective August 2016 through September 30, 2017.
Required
Family Doctor, Name and Telephone number
(if available. if not, leave blank)
Your answer
Family Dentist, Name and Telephone number
(if available. If not, leave blank)
Your answer
Support Role for the RE Program
Our RE program is a cooperative effort. Families with children in the program, who have been attending at least six months, are expected to share their time, talents, and skills with the church community (one role per family is suggested). Please indicate where you would like to help. If you have a particular talent you'd like to share or a way to help that is not listed, please check "other" and indicate your idea. Thank you!
Support Roles involve a minimum of 8 hours per year; you may select more than one area of interest
Required
First Child/Youth
Name of First Child/Youth
(Last name, first name)
Your answer
Date of Birth
(first child/youth)
MM
/
DD
/
YYYY
Grade (or grade equivalent) as of Fall 2016
(first child/youth)
Please list any medical conditions, allergies, or behavioral issues that we should be aware of, and provide information on the best way to support your child/youth in these areas.
(you may also check the box below if you would prefer to speak directly with the RE Director about your child's needs.)
Your answer
Please check the box if you would like the RE Director to contact you about your child's needs.
Second Child/Youth
Name of Second Child/Youth
(Last name, first name)
Your answer
Date of Birth
(second child/youth)
MM
/
DD
/
YYYY
Grade (or grade equivalent) as of Fall 2016
(second child/youth)
Please list any medical conditions, allergies, or behavioral issues that we should be aware of, and provide information on the best way to support your child/youth in these areas.
(you may also check the box below if you would prefer to speak directly with the RE Director about your child's needs.)
Your answer
Please check the box if you would like the RE Director to contact you about your child's needs.
Third Child/Youth
Name of Third Child/Youth
(Last name, first name)
Your answer
Date of Birth
(third child/youth)
MM
/
DD
/
YYYY
Grade (or grade equivalent) as of Fall 2016
(third child/youth)
Please list any medical conditions, allergies, or behavioral issues that we should be aware of, and provide information on the best way to support your child/youth in these areas.
(you may also check the box below if you would prefer to speak directly with the RE Director about your child's needs.)
Your answer
Please check the box if you would like the RE Director to contact you about your child's needs.
Fourth Child/Youth
Name of Fourth Child/Youth
(Last name, first name)
Your answer
Date of Birth
(fourth child/youth)
MM
/
DD
/
YYYY
Grade (or grade equivalent) as of Fall 2016
(fourth child/youth)
Please list any medical conditions, allergies, or behavioral issues that we should be aware of, and provide information on the best way to support your child/youth in these areas.
(you may also check the box below if you would prefer to speak directly with the RE Director about your child's needs.)
Your answer
Please check the box if you would like the RE Director to contact you about your child's needs.
If you have additional children/youth to register, please submit this form and then start a second form.
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