Soulful Exploration 2017 Registration (one per child)
Thank you for allowing your child(ren) or youth to participate in RE and youth programming at WUUC. In order to best serve your child(ren) and family, and to provide prompt emergency attention if necessary, we require the following information in order to have your child(ren) participate in RE. There is no fee to participate in RE and youth programming unless explicitly noted (e.g. Coming of Age, OWL, Youth CONs, etc.). Please fill out a separate form for each child (our database requires it). For questions or to provide more detailed or confidential information, please contact Rev. Jae Scott at dll@wuuc.org. Returning families, please complete our abbreviated update form here. Returning families, please complete our abbreviated update form here: https://goo.gl/forms/9dMiWREVohNIDpgI2
First Name
Your answer
Middle Name
Your answer
Last Name
Your answer
Primary Address Line 1
Your answer
Primary Address Line 2
Your answer
Primary Address City
Your answer
Primary Address Postal Code
Your answer
Home Phone
(xxx) xxx-xxxx
Your answer
Mobile Phone
Your answer
Work Phone
Your answer
Primary Email
Parent Email
Your answer
Alternate Email
Youth's Email Address
Your answer
Birthdate
MM/DD/YY
Your answer
Child Medical/Dietary Alerts
Please indicate any allergies or medical information WUUC should know. If explanation is required beyond this form, please speak with the DLL.
Your answer
Family Physician and Contact
Your answer
Field Trip Permission
I give consent for my child(ren)/youth to participate in field trips sponsored by WUUC. Field trips will be announced in advance and I can revoke this agreement on an individual basis by contacting the DLL, RE Teacher or Youth Advisor. I understand that WUUC does not accept responsibility for any bodily injury incurred during the event.
Medical Treatment
In the event of apparent illness or injury to my child(ren)/youth, I authorize the DLL or WUUC adult sponsor to provide, at my expense, first aid or other appropriate assistance and/or to contact a local doctor in an emergency. I hereby release and absolve the Woodinville Unitarian Universalist Church, its Board of Directors, and authorized Religious Exploration staff from any claim arising out of injury to my child(ren)/youth.
Parent/Guardian Name
Parent/Guardian Name(s)
Your answer
Photo Release Approval
May we have permission to post unnamed pictures of your child(ren) or youth on our public sites (e.g. including but not limited to the WUUC website, Facebook, Newsletter, etc.)?
Photo Release Exception
Your answer
Preferred Gender Pronoun
Preferred Gender Pronoun Other
Or let us know here...
Your answer
School Grade in Sept 2016
Click on the drop down list to select a "grade" relative to kindergarten (e.g. PK2 = will start kindergarten fall of 2018)
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