Unity Church of Dallas - Youth Ministry Registration Card

Infant – 6th Grade

 

Date___________________________________

Parent’s names _________________________________________  Student(s) lives with: ________________________

Address______________________________________________________________ Zip_____________________________

                                street                                                                 city

 

q Add me to your Unity Parents mailing list.

                    Parent’s E-mail Address:______________________________________________________

                   

 

Phone numbers       _______________________   _________________________       _______________________

                                                    (Area code) Home phone                 (Area code) Work phone                         (Area code) Cell phone

 

 

Child’s Name ___________________________  Gender  M   F   Age ______  Birth Date ___________ Grade _________ 

 

Child’s Name ___________________________  Gender  M   F   Age ______  Birth Date ___________ Grade _________ 

 

Child’s Name ___________________________  Gender  M   F   Age ______  Birth Date ___________ Grade _________ 

 

Child’s Name ___________________________  Gender  M   F   Age ______  Birth Date ___________ Grade _________ 

 

List special needs or considerations (allergy, medical, pick-up info, etc.) we should be aware of to best serve your child.

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

 

 

 

To enhance your child’s experience in our Youth Ministry Program, would you be willing to periodically help with:

 

_____    Assist at the Sign-in Desk.

_____    Assist as a Guardian (help getting children to and from Sanctuary, checkout, cleanup).

_____    Teach or assist in classrooms once or twice a month.

_____    Substitute teach or assist, or float once a month in the classroom.

_____    Assist with special events.

_____    Bake or Cook for special events.

 

 

Service we usually attend:   ____  9:00am   ____ 11:00am

 

Photo Release:

 

I hereby give permission to Unity Church of Dallas to photograph my child and use such photographs in all forms of media, for any and all promotional purposes including advertising, publicity, display, and audiovisual uses. I understand the term "photograph" as used herein encompasses still photographs, audio recording and motion picture footage.  I will make no monetary or other claim against Unity Church of Dallas for the use of the photograph(s)/video.

 

Print full name: _________________________________________________

 

Signature: _____________________________________________________

 

Relation to child: _____________________________       Date: _____________________