UUCB Religious Education Registration 2019-2020
Please complete ONE form per family. You will have the opportunity to enter each child/youth within this form. You should receive a follow up email with information for payment/scholarship information withing 48 hours of registration. Please contact Director of Religious Education, Adrienne Summerlot
if you have any questions. THANK YOU!!!
Preferred Name and Pronouns (to display on nametag) ie: Susie (she/her/hers)
Date of Birth (xx/xx/xxxx)
Current School Grade(or home school equivalent) as of August 2019
Less than 3 years old (Childcare program)
Register Child for (you may select multiple for 1 child/youth if applicable ie: HS youth group and Coming of Age)
9:15am- Caring Connections (Childcare)
9:15am- World of Wonder (Preschool)
9:15am- Roots and Wings (Kindergarten +)
11:15am- Caring Connections (Childcare)
11:15am- World of Wonder (Preschool)
11:15am- Roots and Wings (K-2nd grade)
11:15am Curiosity Club (3rd-5th grade)
11:15am- Star Wars (6th-8th Grade)
12:30pm- High School Youth Group (9th-12th grade)
Coming of Age (9th & 10th grade) NOTE: Prior approval must be obtained
Special Needs (Medical, Dietary, Accessibility, etc)
Yes, I release my child’s photo to be included on the Unitarian Universalist Church of Bloomington’s website, facebook and/or prologue newsletter. (Children’s names are never included with photo)
No, I would prefer for my child’s photo to not be taken or used
Do you have additional children to register?
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