2017-2018 Youth Group Registration Form
To Be Filled Out By Youth
Name:
Your answer
Age:
Your answer
Birthdate:
Your answer
Grade:
Your answer
Are you a member?
Your answer
Allergies:
Your answer
Email:
Your answer
Cell phone:
Your answer
Preference for Cell Phone Use:
Best way to communicate with you weekly (text, email, Facebook, etc):
Your answer
Can your email and cell phone information be shared with other Youth Group Members and Teachers?
Tell Us More About You
In the space below, please tell us your interests, hobbies, and talents. What do you like wondering about/learning/teaching? Anything else we should know about wonderful you?
Your answer
To Be Filled Out By Parent
Parent/Guardian's Name
Your answer
Are you a member?
Occupation:
Your answer
Best phone number to reach you:
Your answer
Email:
Your answer
Street Address:
Your answer
City/Town:
Your answer
State:
Your answer
Zip:
Your answer
Parent/Guardian's Name:
Your answer
Occupation:
Your answer
Best phone number to reach you:
Your answer
Email:
Your answer
Street Address:
Your answer
City/Town:
Your answer
State:
Your answer
Zip:
Your answer
Signature of Parent/Guardian:
Your answer
Date:
Your answer
Photo Release and Consent
We occasionally publish photos and videos of fun church events in our monthly newsletter, printed materials and on our website and Facebook page. We don't typically use names, but if we use one for a caption, it is only a first name. Please indicate if you give permission for us to publish photos and videos that include your youth:
Check one:
Field Trip Permission
I give my permission for my youth to participate with the Murray Unitarian Universalist Church at any and all off-campus, church approved events beginning September 2017 and extending to June 2018. I will notify the specific group leaders if my youth does not have permission to attend a specific event. I understand that I will hold neither the supervisory adults nor Murray Unitarian Universalist Church or any of its agents liable for injuries or damages sustained by my youth during any off-campus, church sponsored events.
Overnight at Murray Church
I give my permission for my youth to attend an overnight at Murray Church. My youth will follow all the guidelines and rules pertaining to the event. I agree to hold harmless Murray Unitarian Universalist Church and its leaders for any accident or injury resulting from this event. I give permission to designated Youth Advisors to seek medical care for my youth if I cannot be reached.
Parent Emergency Name:
Your answer
Parent Emergency Phone Number:
Your answer
Other Emergency Name:
Your answer
Other Emergency Phone Number:
Your answer
Relationship to Youth:
Your answer
Parent Volunteering
Please let us know how you can help with our Youth Group:
Please feel free to reach out to Kavita Vansant, our Lifespan Director of Religious Education if you have questions and/or comments at kkvansant@gmail.com
Stay Connected
You can always know what is happening in our Religious Education Program! We have a web page (www.murrayuuchurch.org), and we are on Facebook. Plus check out our newsletter for our weekly RE calendar! Check us out!
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