2024-2025 May Memorial and First UU RE Registration

May Memorial & First UU Society of Syracuse Religious Education Registration
Welcome to the 2024-2025 RE registration form. All children and youth who participate in the nursery through Teenz at either May Memorial, First UU, or both congregations, need to have this registration form on file each church year. Thank you for your cooperation, Tina and Stacy
Primary Church Community (You may select both if applicable)*

First UUMay Memorial
Parent 1 *

First NameLast Name
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
May we text you at this number?

YesNo
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent 2

First NameLast Name
E-mail
example@example.com
Phone Number

Area CodePhone Number
May we text you at this number?

YesNo
Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Online Communication with Children and Youth
Please note that it is our policy to always have two adults in the room when children and/or youth are involved and this includes in a virtual space or with online communication. When an adult reaches out to youth via email or text a second adult will be added into the conversation. It is our goal to model healthy boundaries to keep children and youth safe.
Child 1*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
E-mail (7th-12th grade only)
example@example.com
Cell Phone # (7th-12th grade only)

Area CodePhone Number
Child 2

First NameLast Name
Birth Date

MonthDayYear
Grade
E-mail (7th-12th grade only)
example@example.com
Cell Phone # (7th-12th grade only)

Area CodePhone Number
Child 3

First NameLast Name
Birth Date

MonthDayYear
Grade
E-mail (7th-12th grade only)
example@example.com
Cell Phone # (7th-12th grade only)

Area CodePhone Number
Additional children
Emergency Contact other than Parents*

First NameLast Name
Phone Number*

Area CodePhone Number
Medical Doctor Contact Info*

First NameLast Name
Phone Number*

Area CodePhone Number
Medical Insurance Provider
Policy Number
Please share any information that will help us better support your child(ren) in the box below. Include any special needs or medical conditions we need to be aware of. If not applicable, type NONE.
Special needs or allergies. If none, please type NONE in the box*
May we use your child's picture on church bulletin boards, and in church emails?*

YesNo
May we use your child's picture on-line? No names will be used.*

YesNo
By clicking YES I give permission for my child(ren) to participate in religious education at First UU or May Memorial*

Yes I give permissionNo I do not give permission
Thank you EVERYONE for caring about our children and youth, for your support, and your valuable time!
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May Memorial & First UU Society of Syracuse Religious Education Registration