United Parish Children & Youth 2020-2021 Registration Form

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Please fill out a separate form for each child in your household

Email *

Church School Class: *

Nursery (for children age 5 and younger)

Preschool - Kindergarten

Elementary (1st - 5th grades)

Middle School (6th - 8th Grades)

High School (9th - 12th Grades)

Required

Children/Youth Choir

Cherubs (Age 3- Kindergarten)

Carolers (1st - 5th Grades)

Youth Choir (6th - 12th Grades)

Clear selection

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?

Second Adult on Zoom (help with muting/unmuting, admitting into classroom, etc)

Substitute Teacher (via Zoom only)

Substitute Teacher (in-person only)

Substitute Teacher (via Zoom AND in-person)

Church School Greeter (once in-person Church School resumes)

Buy Snacks (once in-person Church School resumes)

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

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?

Is there anything else you would like us to know about your child?

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

Briefly, how has your child responded to life during the pandemic (quarantine, online-learning, social-distancing, etc)? *

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 2020-2021 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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