Registration for Children’s Faith Exploration 
Unitarian Universalists of Southern Delaware
30486 Lewes Georgetown Highway
Lewes, DE 19958
302-313-5838 uussd.org

Please complete the Registration for Children's Faith Exploration form as part of the registration process for UUSD's program for children and youth. The form will take about five minutes to complete. In addition, you are asked to complete a Media Release Form for Children and Youth Under Age 18. If you have any questions, please contact the Director of Children's Faith Exploration at CFEDirector@uussd.org.
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Email *
Parent or Guardian 1 Information 
Name Parent or Guardian 1 Information *
Cell Phone  *
Address *
Email Address *
Parent or Guardian 2 Information 
Parent or Guardian 2 Information Name
Cell Phone 
Address
Email Address
Child Information 
Once you have completed information for each of your children you are registering, please scroll down to  Transportation and Custody.
Child 1 Information
Child 1 Information Name *
Birth Date *
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Age *
School Grade *
School *
Child's address if different from above 
Child 2 Information 
Child 2 Information   Name
Birth Date
MM
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DD
/
YYYY
Age
School Grade
School
Child's address if different from above 
Child 3 Information 
Child 3 Information   Name
Birth Date
MM
/
DD
/
YYYY
Age
School Grade
School
Child's address if different from above 
Child 4 Information 
Child 4 Information   Name
Birth Date
MM
/
DD
/
YYYY
Age
School Grade
School
Child's address if different from above 
Transportation and Custody
Child/Children will be brought to UUSD by: *
If other, specify.
Please describe any custody issues that we should be aware of.
Parent's/Guardian's Contribution to Children's Faith Exploration
Our cooperative Children's Faith Exploration (CFE) Program depends upon our volunteer teachers who share the responsibility for nurturing our children’s spiritual growth. We would love for you to share your knowledge, gifts, and/or talents with our children.
I would consider:
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I would be willing to volunteer on a monthly basis:
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Please list any specific areas of interest, talents, or hobbies you would like to share.
Safety and Special Instructions

Please describe any medical conditions or allergies, learning needs, behavioral issues, or dietary needs your child/children may have. If you have any questions or additional comments, please contact Children’s Faith Exploration at CFEDirector@uussd.org.

Child 1 Safety and Special Instructions
Child 2 Safety and Special Instructions
Child 3 Safety and Special Instructions
Child 4 Safety and Special Instructions
Emergency Contact and Phone Number *
Additional Information in Case of Emergency (Optional)
Authorization for Emergency Medical Treatment
Should any injury occur, I grant permission for my child to receive treatment from an appropriate health care provider when the need for such treatment is deemed immediate and when efforts to contact me (us) are not successful. I agree to pay and be responsible for all medical, hospital, or other expenses that my child may incur as a result of such treatment.
Release Statements   
I agree and hereby do release and hold harmless the Unitarian Universalists of Southern Delaware and its agents from and for any and all liability that may arise from damages, loss, or injuries, either to person or property, which my child may sustain while engaged in any activity connected with Children’s Faith Exploration.

I further agree to assume responsibility for any liability that may arise for damages, loss or injuries, as described herein that may be caused or contributed to or by my child to the person or property of others.
Parent/Guardian 1 – Type Name and Date.
Parent/Guardian 2 – Type Name and Date.
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