Cell Phone of 2nd Parent/Caregiver (if applicable)
Your answer
Name of Child
Your answer
Birthday
Your answer
Grade (if applicable)
Your answer
Gender Identity and Preferred Pronouns (optional)
Your answer
Please let us know anything to help support your child in religious education (food allergies, health concerns, mental health needs, learning styles, family arrangements, etc.). If possible, please describe ways to best support your child:
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Emergency Contact - Name & Relationship *
Your answer
Emergency Contact - Phone Number *
Your answer
Name and Phone Number of Child's Physician *
Your answer
I understand that every attempt will be made to contact me first, but in the event I cannot be reached, I give permission to the staff and volunteers of TUC to give first aid and/or take my child either to the nearest medical facility and to call our child's physician. I give our child's physician and/or medical facility permission for any and all procedures necessary for the treatment of my child. This release and consent shall be effective until revoked in writing by the undersigned. *
Medical Release: On behalf of my child, I hereby release and discharge Third Unitarian Church from any claims from incidents which may occur during Religious Education program activities. In the case of a medical emergency, I, as parent or guardian of the minor child registered, shall be immediately contacted by TUC if and to the extent such contact is practicable. *
Media Release: We may occasionally take photos or videos of young people in our RE program to help communicate about our program. These photos and videos may be shared in various ways. Please check how photos and videos of your child may be shared:
Communications with Youth: If you are registering a youth (ages 12-18) we may like to occasionally text your youth about upcoming events. Our practice is to have 2 adults on text messages with youth. Do you give permission for TUC staff and RE volunteers to contact your youth via their cell phone?
If yes, please provide your youth's cell phone number below, if they have one.
Your answer
Our RE Program is a cooperative endeavor among all members of the congregation to nurture the spiritual lives of our children, youth and families. Please check all the ways that you are interested to participate. Thank you so much!
Please use this space to share about anything that might help us support your child's participation in our program. Thank you!