Child & Youth Program Registration

All Faiths Unitarian Congregation Child & Youth Program Registration

Please complete this registration for each child/youth participating in any All Faiths child or youth program and/or activities. Thank you.
Parent / Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Phone number where adult can be reached during the program or activity.
E-mail*
example@example.com
Child / Youth Name*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Please list any allergies.
Please describe your child's learning style.*
Add a child
Child / Youth Name*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Please list any allergies.
Please describe your child's learning style.*
Add a child
Child / Youth Name*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Please list any allergies.
Please describe your child's learning style.*
Add a child
Child / Youth Name*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Please list any allergies.
Please describe your child's learning style.*
I give permission for All Faiths to use images of my youth(s)/child(ren) in their newsletter and social media.*

YesNo
I give permission for the child(ren)/youth(s) named above to attend the All Faiths Child and Youth Program. I hereby release All Faiths, its employees, agents and volunteers, from any and all liability, claims, demands, causes of action and possible causes of action whatsoever arising out of or related to any loss, damage or injury that may be sustained by my child while participating in this program.
Confirm permission to attend:*

Yes
Signature*

Clear
Should be Empty:

All Faiths Unitarian Congregation Child & Youth Program Registration