Unity Temple Unitarian Universalist Congregation
2016-2017Religious Education Registration

Parent Information
Name: / Phone:
Address: / Email:
City/State/Zip:
Child Information
Name / 2016-2017Grade Level / Date of Birth

One Service at United Lutheranat 11:00 AM

When we return to Unity Temple, which service do you plan on attending: 9 or 10:45? (please circle one)

Does your child have any food allergies or dietary restrictions? Please provide details:

Is there anything about your child/children’s health, learning style, life circumstances, or behavior that would be helpful for us to know?

Please contact Rev. Emily if there are special accommodations that may need to be made for your child(ren) in our program.

We enjoy using pictures of our children in our church literature, displays, and website. If you do NOT wish to have your child(ren)’s picture used in such a way, please indicate any restrictions here. Names will not be put on website. (Blank indicates okay.)______

Fees (used to provide curricula, supplies, training, etc. for our RE program)
$50.00/child: first time registrants, pledging members and friends / $100.00 /child: Non-pledging members and friends
Scholarships available upon request
Payment Information / Credit Card Information(Visa, MasterCard, AmEx)
# of Children: / Name on Card:
Amount Paid: / Number:
 Cash Check  Credit/Debit Card _ Info on file at office / Exp. Date: Security Code:
Volunteers
Our program is almost entirely dependent upon the gifts of our volunteers. We will be expecting all parents/guardians of preschool through 8th graders to share their presence in our classrooms as assistants. Please indicate other ways in which you might be willing to share your talents and presence with our young people below. THANK YOU SO MUCH!
Parent/Guardian #1: / Parent/Guardian #2
Grade Preference (circle): / Grade Preference (circle):
Nursery Preschool / Nursery Preschool
K 1 2 3 4 5 6 7-8 OWL Coming of Age High School / K 1 2 3 4 5 6 7-8 OWL Coming of Age High School
Class Leader
Takes responsibility for teaching class approximately twice a month and facilitates communication between class and parents. / Class Leader
Takes responsibility for teaching class approximately twice a month and facilitates communication between class and parents.
RE Committee:
Meets monthly to monitor and discuss all aspects of Religious Education Programming; classroom experience required / RE Committee:
Meets monthly to monitor and discuss all aspects of Religious Education Programming; classroom experience required
Special Projects/Events
Help with faith in action projects, pageant, etc. OR willing to share interest, passion or talent (indicate any specifics below) / Special Projects/Events
Help with faith in action projects, pageant, etc. OR willing to share interest, passion or talent (indicate any specifics below)
Party Planner
organizeone social activity for classroom group / Party Planner
organizeone social activity for classroom group

Additional Notes:

Please return to: Rev. Emily Gage 805 South Blvd Oak Park, IL 60302 708-848-6225 X103

PLEASE SEE REVERSE FOR COVENANT FOR CHILDREN AND YOUTH