Unitarian Universalists of Clearwater

Religious Education for Children and Youth

Registration for 2010-2011

 (Classes begin September 19, 2010 at 10:30 am)

 

 

 

 

Parent(s)/Guardian _______________________________________________________________

 

Address _________________________________________________________________________

                                       street                                        city                                     state     zip code

 

E-mail ___________________________________________ Phone _________________________

 

 

Name of Child/Youth #1 ___________________________________________________________

 

Grade (or equivalent) as of 9/1/10 ____ Date of Birth_____________

 

Interests, eating habits, food allergies, special needs, etc… 

 

________________________________________________________________________________

 

________________________________________________________________________________

 

________________________________________________________________________________

 

 

Name of Child/Youth #2 ___________________________________________________________

 

Grade (or equivalent) as of 9/1/10 ____ Date of Birth_____________

 

Interests, eating habits, food allergies, special needs, etc… 

 

________________________________________________________________________________

 

________________________________________________________________________________

 

________________________________________________________________________________

 

 

Name of Child/Youth #3 ___________________________________________________________

 

Grade (or equivalent) as of 9/1/10 ____ Date of Birth_____________

 

Interests, eating habits, food allergies, special needs, etc… 

 

________________________________________________________________________________

 

________________________________________________________________________________

 

________________________________________________________________________________

 

Please complete the other side too!


2

 

 

 

Throughout the church 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:

 

 

____ YES I grant the staff and volunteers of the Unitarian Universalists of Clearwater permission to photograph my child(ren).

 

 

____ NO I do not grant the staff and volunteers of the Unitarian Universalists of Clearwater permission to photograph my child(ren).

 

 

 

________________________________________________________________      _____________

                                       signature of parent/guardian                                                            date

 

 

 

 

**** We do not charge a fee for the Religious Education program. If you would like to make a voluntary donation, checks can be payable to: Unitarian Universalists of Clearwater.  In the memo section please write “RE Program Contribution”.