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OUUC 2024 Chalice Camp: "Building a New Way" Registration
OUUC Chalice Camp “Building a New Way” for ages 5-10 will be July 15th to 19th. Open to all, pay what you can sliding scale.
If your child is interested but just out of age range, contact us at
REassistant@ouuc.org
to talk it over to make sure it is a good fit for them.
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Email
*
Your email
Child's name
*
First, Last,
Your answer
Child's preferred name and gender pronoun
Your answer
Child's birthdate
MM
/
DD
/
YYYY
Grade and Age
Your answer
Please tell us about any special needs, allergies, medications, dietary restrictions, or anything else that would impact our care for your child
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What else would you like us to know about your child?
Your answer
Custodial Situation
Living with sole parent/guardian (no other guardians)
Living with both parents/guardians
Parents/guardians live apart, joint custody
Parents/guardians live apart, one has sole custody
Other situation (please explain below)
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Other Custodial situation
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Anyone who is not allowed pick up your child?
*
Your answer
Primary Parent/Guardian (will be the one to receive emails/messages about the program)
*
First, Last
Your answer
Primary Parent/Guardian email
*
Your answer
Phone
Your answer
Street Address
Your answer
City
Your answer
State
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Zipcode
Your answer
Second Parent/Guardian/Caregiver
First, Last
Your answer
Second Parent/Guardian/Caregiver phone
Your answer
Emergency Contact name
*
First, Last,
Your answer
Emergency Contact phone
*
Your answer
I give permission for my child's picture to be taken and used in publications
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Pictures taken are only used on the congregation's website, blog, and in print publications.
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