The Universalist Church

433 Fern Street, West Hartford, CT 06107

RELIGIOUS EDUCATION REGISTRATION FORM 2015-2016

Materials Fee: $30 per child / $100 family maximum (due at time of registration)
Parental support is needed for our cooperative program.

PLEASE COMPLETE BOTH SIDES OF THIS FORM

PARENT INFORMATION

(Please print)

First Parent (guardian)

Second Parent (guardian)

Name___________________________________________

Name______________________________________________

Address_________________________________________

Address____________________________________________
Town____________________________ Zip _____________

Town__________________________ Zip _____________

Cell phone _________________ Home _______________
E-Mail__________________________________________

Cell phone __________________ Home _________________

E-Mail____________________________________________

STUDENT INFORMATION
Children in grades 2 and under should be picked up in their classrooms by parents after the service.
1) Students Name_____________________________

2) Students Name___________________________________

Birth date____________________________________

Birth date __________________________________________

School Grade or Age (fall 15) ___________________

School Grade or Age (fall 15) _________________________

Concerns/Allergies_____________________________

Concerns/Allergies___________________________________

3) Students Name_____________________________

4) Students Name___________________________________

Birth date_____________________________________
School Grade or Age (fall 15) ____________________

Birth date___________________________________________

Concerns/Allergies______________________________

School Grade or Age (fall 15)___________________________

Concerns/Allergies____________________________________

* SPECIAL NOTE REGARDING PLEDGING:

Our Religious Education programs cost approximately $400 per child annually. Materials fees cover
only classroom and event supplies. To continue the quality of our programming, it is essential that
families in the Religious Education program financially support the Church with a minimal pledge of
$400 per child or through regular contributions to the Church. If there is a financial hardship, please
contact the Religious Education Director or the Senior Minister for alternative plans.

***PLEASE COMPLETE BACK OF FORM***

Photo, Audio and Video Release

I grant permission to the Universalist Church of West Hartford to use image(s) of myself and/or my
family in photographs, audio, and/or video recordings (hereafter, media). These media may include,
but are not restricted to the Churchs website, Facebook pages, newsletters, and other publications for
Church publicity purposes. I understand that my/our name will not be used without prior permission.
If I wish to withdraw my permission I agree to submit my request in writing at which time the
Universalist Church will have up to two weeks from the date of receipt to withdraw the photograph(s)
from the website or otherwise discontinue using the photograph(s) as requested.
______ I have read and agree to the terms and conditions stated above.
______ I do not give permission to use images of myself and/or my child(ren) with the exception of
photographs of large groups in the congregation in which they may appear.
______ I do not give permission to use images of myself and/or my child(ren).
Printed Name ________________________________________________

Parent Volunteer Opportunities for 2015-2016

Ours is a cooperative church school. At least one parent from each church school family is
expected to participate on a religious education team every year and to teach every other year.
Please volunteer for one of the following:

Teaching Team
As a parent, teaching in the church school is one of the most rewarding things you can do for
yourself and for your children. Past teachers have liked learning and interacting with the
children, the ease of the commitment, working with and meeting other parents, and
watching the children learn about being UUs, expressing and exploring their vg friendships.
_________________________________will join a Teaching Team
Grade Preference:

Nursery

Preschool

Primary

Third-Sixth

Junior High

Connections Team
If you enjoy rolling up your sleeves and making a difference in the world, this is the team for you.
It is especially exciting to lay the groundwork for the children to become more involved in social
action initiatives. Monthly team meetings are on Sunday mornings.
_________________________________will join the Connections Team

RE Support Team
Needs arise over the course of the year, so its important to have a pool of volunteers ready to
pitch in. This could be assisting in classroom as a substitute teacher, or helping with childrens
worship or with holiday and special programming. There are also openings in leadership positions
such as RE Transitions and RE task forces.
_________________________________will join the RE Support Team

________________________________________________
Parent Signature

___________________
Date