United Parish Children & Youth 2021-2022 Registration Form

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For parents of multiple children, we ask you to please fill out a separate form for each child, but feel free to write "Same" in any field with duplicate information (address, parent contact, etc).

Email *

Church School cohort (this is very general- we will be sorting into Elementary 1&2, confirmation, etc) *

Nursery (for children age 5 and younger)

Preschool - Kindergarten

Elementary (1st - 5th grades)

Middle School (6th - 8th Grades)

High School (9th - 12th Grades)

Required

Music programming *

My child plans to participate in music activities outside of church school

My child does not plan to participate in music activities outside of church school

We're not sure- could you send us more information on the offerings?

Student's Name: *

Student's Pronouns: *

Student's Grade *

Student's Birthday *

YYYY

Student's School: *

Student's Cell Phone (if no cell phone, write "none") *

Student's Email (if no email, write "none") *

Parent/Guardian #1 Name: *

Parent/Guardian #1 Mailing Address: *

Parent/Guardian #1 Phone: *

Parent/Guardian #1 Email: *

Parent/Guardian #2 Name (if applicable)

Parent/Guardian #2 Mail Address (if different from Parent 1)

Parent/Guardian #2 Phone (if different from Parent 1)

Parent/Guardian #2 Email (if different from Parent 1)

Best Form of Contact?

by Email

by Phone Call

by Text Message/SMS

In which ways are you willing to volunteer?

Substitute Teacher

Church School Greeter (9:30am-10am; greet families as they arrive and help direct to class)

Church School Ambassador (help welcome and orient new families, involves 2-3 email/phone or in-person check-ins)

Volunteer for intergenerational events

Other one-off tasks, as needed

What medication, if any, does your child regularly take?

Does your child have any allergies? If yes, please describe triggers and treatments. *

Is your child enrolled in an Individual Education Plan (IEP) or have any special needs? If so, please give us as much information about your child as you feel comfortable giving, including how we may best accommodate, welcome, and affirm them.

Do you have any other tips or suggestions that may help teachers accommodate, welcome, and affirm your child?

What other extracurricular activities is your child involved in?

In the past year, have there been any major life changes or significant events that it would be useful for our pastoral team to know about? *

What are your hopes or goals for your child's church school experience this year? *

FOR CHILDREN IN 5th GRADE OR ABOVE: I give my child, named below, permission to participate in adult-supervised Church School and Choir activities either by walking, traveling in a car or bus, or taking public transportation during the 2021-2022 church school year. Parent/guardian will be contacted in the event of serious sickness or accident. However, in the event of an emergency, I hereby authorize representatives of United Parish in Brookline to obtain necessary emergency medical treatment for my child. PLEASE WRITE CHILD'S NAME, YOUR NAME, AND DATE BELOW:

Send me a copy of my responses.

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