UU/Sangha Children's Program: Intake Form for Religious Exploration/Meditation Children's Program

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Hello! This is Paul Bodily with the Children’s RE/meditation program at the UU/Sangha. We’re grateful to have your children attend the program! If you’re receiving this message it is to invite you to fill out the Intake Form to get a little more info about your children (e.g., allergies, medical conditions, emergency contacts, primary language, etc.). This form needs to be completed once per child. There will be a separate Child Sign-in/Sign-out sheet that you will need to fill out each time you drop off/pick up your child at the UU building.

Email *

Record my email address with my response

Child First Name *

Child Last Name *

Child Preferred Name (if other than First Name)

Child Date of Birth *

YYYY

Child Allergies or Dietary Restrictions (enter None if none) *

Special Needs or Medical Conditions (enter None if none) *

Primary Language Spoken at Home *

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