UUC Religious Enrichment Registration Form 2020-2021
Welcome to UUC's Religious Enrichment Program!

We do not charge a fee for the program. If you would like to make a donation, see options at https://www.uuc.org/giving, and donate to the General Fund.
Parent/Guardian Name(s) *
Parent/Guardian Cell Phone Number(s) *
Parent/Guardian Email Address *
Physical Mailing Address *
Emergency Contact Information (In case parent/guardian cannot be reached, please provide name, relationship to student, and cell phone number here.) *
Child/Youth 1: Name & Pronouns *
Child/Youth 2: Name & Pronouns
Child/Youth 3: Name & Pronouns
Child/Youth 4: Name & Pronouns
Child/Youth 5: Name & Pronouns
Child/Youth 1: Date of Birth *
MM
/
DD
/
YYYY
Child/Youth 2: Date of Birth
MM
/
DD
/
YYYY
Child/Youth 3: Date of Birth
MM
/
DD
/
YYYY
Child/Youth 4: Date of Birth
MM
/
DD
/
YYYY
Child/Youth 5: Date of Birth
MM
/
DD
/
YYYY
Child/Youth 1: Grade
Child/Youth 2: Grade
Child/Youth 3: Grade
Child/Youth 4: Grade
Child/Youth 5: Grade
Child/Youth 1: Email Address (if applicable)
Child/Youth 2: Email Address (if applicable)
Child/Youth 3: Email Address (if applicable)
Child/Youth 4: Email Address (if applicable)
Child/Youth 5: Email Address (if applicable)
Child/Youth 1: Allergies/Medical Notes
Child/Youth 2: Allergies/Medical Notes
Child/Youth 3: Allergies/Medical Notes
Child/Youth 4: Allergies/Medical Notes
Child/Youth 5: Allergies/Medical Notes
Throughout the year, there will be opportunities for photos to be taken of children and youth. Should the photos be displayed on the church website, they will not be identified by name to ensure the safety and privacy of our children and families. Please make a selection below: *
Signature of Parent/Guardian *
Date of Signature *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of Unitarian Universalists of Clearwater. Report Abuse