2025-2026 Children and Youth Programming Registration Form

This form is for all children and youth ages 0–18 who will participate in any part of UUMAN’s Ministry for Children and Youth (MCY) programming, including Nursery, Children’s Chapel during the first hour, Religious Exploration classes, and special events.
Questions or concerns? Contact Lexie T. Brown, Director of Religious Exploration, at DRE@uuman.org.

Youth's Information

Name

Pronouns

she/her he/him they/them My Choice Not Listed

Birthdate

Phone

Do you wish to receive Text Messages?

yes no

By selecting "Yes" above, I am consenting to receive SMS messages from Breeze regarding information and announcements for UUMAN. I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time. For support I can text HELP to 87447. Please review the Breeze Privacy Policy and Terms of Service available at breezechms.com for more details.

Would you like to be added to the community group chat for parents/guardians?

Yes No Unsure

This address will receive a confirmation email

Address

County

Allergies (& type of reaction)

Dietary Restrictions (non-allergies)

Medical Conditions/Concerns

Anything you want the RE team to know that could effect participation?

Consent

Medical Release: on behalf of my child(ren), I hereby release and discharge UUMAN from any claims from incidents which may occur during Faith Development programming activities. In the case of a medical emergency, I, as parent or guardian of the minor child(ren) registered, shall be immediately contacted by UUMAN and to the extent such contact is practical. This release and consent shall be effective until revoked in writing by the undersigned.

Guardian's signature (typed)

Photos

Permissions for sharing photos or videos of your child(ren) internally (bulletin boards, email annoucements) and externally (newsletter, website)

Photo Permission

Yes No

Parent/Guardian Information

Name

Email address (if different from youth's email)

Phone number (if different from youth's phone)

Name(s) of other Parents/Guardians/Caregivers *Please note that if an adult's name is not listed here, they will not be allowed to pick kids up from programming i.e grandparents, friends, etc.

Help and Support

The strength of our program depends on everyone's support. All parents/guardians are asked to volunteer their time during the year. Options include: RE teacher, children and youth special events, childcare for church activities, youth group advisor or youth mentor. If you are able to volunteer, please list any interests. RE instructor RE substitute Nursery Special Events Coming of age Mentor (middle school) MCY team Family Potlucks OWL instructor/ assistant

Tell us if your family has a fun Sunday ritual: Bagles on the way to church? Or maybe pancakes after RE?

Would you like to be contacted by the OWL coordinator to enroll your children/youth in OWL? yes no

2025-2026 Children and Youth Programming Registration Form

Description

Please Fix the Following