We do not charge a fee for the Religious Education program. If you would like to make a voluntary donation, make checks payable to: Unitarian Universalists of Clearwater. In the memo section please write “RE Program Contribution”.
Unitarian Universalists of Clearwater
2470 Nursery Road
Clearwater, FL 33764
2011-2012 Registration Form for Religious Education Classes for Children & Youth
(Classes begin September 25, 2011 at 10:30 am - High School Youth Group meets 12-1 pm)
Parent(s)/Guardian (required):
E-mail (required):
Address (next 4 boxes required):
Street Address
City
State FL
ZIP Code
Phone
Child/Youth (next 3 boxes required):
Name
Grade (or equivalent) as of 9/1/11
Date of Birth
Child/Youth E-mail (optional)
Interests, eating habits, food allergies, special needs, etc. (optional):
How many children/youth are you registering on this form (1-5)? (required)
----------------------------------------------------------------------------------------------- (Use this space for registering additional Child/Youth names. If you are registering more than five names, please complete the form and click on the Send button below, and then use the form again to register additional names.)
Child/Youth:
Name
Grade (or equivalent) as of 9/1/11
Date of Birth
Child/Youth E-mail
Interests, eating habits, food allergies, special needs, etc:
Child/Youth:
Name
Grade (or equivalent) as of 9/1/11
Date of Birth
Child/Youth E-mail
Interests, eating habits, food allergies, special needs, etc:
Child/Youth:
Name
Grade (or equivalent) as of 9/1/11
Date of Birth
Child/Youth E-mail
Interests, eating habits, food allergies, special needs, etc:
Child/Youth:
Name
Grade (or equivalent) as of 9/1/11
Date of Birth
Child/Youth E-mail
Interests, eating habits, food allergies, special needs, etc:
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. Do you grant the staff and volunteers of the Unitarian Universalists of Clearwater permission to photograph your child(ren)?
Permission granted
Permission not granted
Note: Clicking on the Send button below is the same as Signing the form, it indicates you are satisfied with all the selections you have made on the form. Later on, if you choose to make a change, please phone Christine Pensa at (727) 644-1313.
Click on the Send button. After the form is sent to Christine
Pensa, you will be switched to the UUC Home Page!
You will receive a copy of the information in this form by email.