SUUS Religious Exploration Registration Form: Children & Youth 2024-2025

Parent or Guardian #1

Name

This address will receive a confirmation email

Phone

Address

Parent or Guardian #2

Name

Phone

Address

Child Information

#1 Child’s first and last name:

Date of Birth:

Grade as of September 2024

Medical Concerns /Allergies*

* Please list all allergies, including food, animals, pollen, insects, medication, etc., and note any treatment that could be required at church.

Pronouns:

#2 Child’s first and last name:

Date of Birth:

Grade as of September 2024

Medical Concerns /Allergies*

Pronouns:

#3 Child’s first and last name:

Date of Birth:

Grade as of September 2024

Medical Concerns /Allergies*

Pronouns:

Getting To Know Your Child Better

Are there any family circumstances we should be aware (e.g., custody issues)?

YES NO

If yes, please describe.*

Are there any learning or developmental differences that might affect your child’s experience?

YES NO

If yes, please describe.*

Does your child have a learning style and/or any physical or emotional challenge that may affect their behavior in our programs?

YES NO

If yes, please describe.*

Is there anything else that we should know about your child that would help us serve them better?

Privacy

Information Sharing - It is our intent to treat the information on this form with sensitivity and care, while ensuring that adults who have responsibility for your child(ren) have the information they need. This information will be shared as needed with program volunteers and staff. If you have an objection to the sharing of any information in this manner, please specify:

Photo/Video Release and Signature - Occasionally, we like to take pictures or videos of the children as they participate in Faith Formation or other SUUS activities. Such images may be posted in the building (bulletin boards), SUUS website, SUUS facebook page, newsletter, promotional materials, print or online publications (e.g. Region/UUA publications, local newspapers or news websites). We do not publish or display names or other identifying information with photos, without first obtaining parent/guardian permission.

Please indicate whether or not you give consent for the use of your child(ren)'s images as indicated above. You may revoke or alter this permission at any time with written notification to the Director of Faith Formation (dff@shorelineunitartian.org).

YES, I give consent for SUUS to use my child(ren)'s images as indicated above. NO, I do NOT give consent for SUUS to use my child(ren)'s images as indicated above.

Electronic Signature

If you do NOT want your child’s picture used in this way, please indicate any restrictions here:

In Case of Emergency

If I/we cannot be readily located in the event of an emergency, I/we authorize SUUS and its representatives to render emergency medical assistance to my child(ren)and to authorize medical and paramedical personnel to do the same.

I/we further give permission for my child(ren) to leave SUUS under the supervision of program leaders for walking trips and related activities during the Sunday morning program (field trips outside of class time or requiring transportation will use a separate permission slip).
I/we also understand that, although SUUS follows policies and practices that it believes to be reasonable to protect children, injuries may still occur. I/we release SUUS and all its representatives from any and all claims and liability for any injury to any child of mine, and agree to indemnify and hold SUUS and all of its representatives harmless against any such claims and liability.

Electronic Signature

To provide the best programming for our children and youth, adult volunteers are always needed! Please consider how you can help, even if it's to share ideas! Let us know your interests and preferences. The Director of Religous Exploration is available to discuss details of any of these possibilities.

Adult Volunteer Options Assist/Hangout with our amazing children & youth! (*Must complete a background check) Become a Youth Advisor (*Must complete a background check) Become a Religious Exploration Committee Member Plan/lead/assist a Social Justice Activity Become an OWL Facilitator Be a Little Free Library Steward Lead a Religious Exploration Event! Assist with Nursery Care (*Must complete a background check)

What specific talents, resources or ideas might you offer?

Thank you for taking the time to fill out our online registration!
If you have questions or would like further information,
please contact:

Religous Exploration Team Co-Chairs:
Jennifer Swenson (swensonj@snet.net)
Scott Swenson (swenson@hotmail.com )

SUUS Religious Exploration Registration Form: Children & Youth 2024-2025

Description

Please Fix the Following