Unitarian Society of Ridgewood

Cooperative Religious Education Program

REGISTRATION FORM 2005-2006

Welcome to our religious education program. Nursery through 5^th grade will meet at 9 a.m. and 11a.m. 6^th grade will meet at 9 a.m. only. Junior Seminar (Grades 7 & 8) will meet at 9 a.m. only. Senior Youth Group (Grades 9-12) will meet at 11 a.m. only. Please indicate the time you are most likely to attend and we will confirm this with you in August.

(Circle One) 9 A.M. 11 A.M.

(1) Child’s/Youth’s Name _______________________________________________________________

Date of Birth ___________________________ Grade (Sept. of 2005) _________________________

Allergies, relevant existing medical conditions, special needs (i.e. fears, different learning styles, etc.) or anything else you would like to share with us about your child/youth to enhance their RE experience:

____________________________________________________________

(2) Child’s/Youth’s Name _______________________________________________________________

Date of Birth ___________________________ Grade (Sept. of 2005) _________________________

Allergies, relevant existing medical conditions, special needs (i.e. fears, different learning styles, etc.) or anything else you would like to share with us about your child/youth to enhance their RE experience:

____________________________________________________________

(3) Child’s/Youth’s Name _______________________________________________________________

Date of Birth ___________________________ Grade (Sept. of 2005) _________________________

Allergies, relevant existing medical conditions, special needs (i.e. fears, different learning styles, etc.) or anything else you would like to share with us about your child/youth to enhance their RE experience:

____________________________________________________________

PARENT INFORMATION

Name of Parent(s) (1) ______________________________ (2) _______________________________

Address_______________________________________________________________________________

Home Phone __________________________ Email ___________________________________________

PERMISSION

My child(ren) or youth (Circle One) does/does not have my permission to accompany their RE Class on walks around the Society or neighborhood on Sunday mornings.

I (Circle One) do/do not grant permission for the Unitarian Society of Ridgewood to submit my child(ren)’s photograph for news articles to local papers. I understand no names will be submitted with the photograph.

Parent/Guardian Signature ______________________________________ Date ___________________

Ours is a Cooperative Program – We can’t do it without YOU!