2009 - 2010 Columbine Unitarian-Universalist Church Religious Education Registration for Young People Please use this form to register children for religious education classes. You may submit the form online or fill out and print the form for submittal in person to Martin Blue-Norton, CUUC Director of Life-Span Education

1. First and Last Names of Each Child 2. Birthdate: Mo/Da/Year Child 1 Child 2 Child 3 Child 4 Child 5 3. Grade Each Child Will Attend Child 1 Preschool (toddlers through age 5) Primary Class - grades K-1-2 Intermediate Class - grades 3-4-5 Junior High Class - grades 6-7-8 High School Child 2 Preschool (toddlers through age 5) Primary Class - grades K-1-2 Intermediate Class - grades 3-4-5 Junior High Class - grades 6-7-8 High School Child 3 Preschool (toddlers through age 5) Primary Class - grades K-1-2 Intermediate Class - grades 3-4-5 Junior High Class - grades 6-7-8 High School Child 4 Preschool (toddlers through age 5) Primary Class - grades K-1-2 Intermediate Class - grades 3-4-5 Junior High Class - grades 6-7-8 High School Child 5 Preschool (toddlers through age 5) Primary Class - grades K-1-2 Intermediate Class - grades 3-4-5 Junior High Class - grades 6-7-8 High School 4. Allergies or Food Restrictions Child 1 Child 2 Child 3 Child 4 Child 5 5. Parent or Guardian Contact Information Name   Name Address City State Zip Code Email Home Phone Work Phone     6. Secondary Contact Name Address City State Zip Code Email Home Phone Work Phone 7. Special Issues (learning concerns, custody issues, etc.)   8. Are you interested in teaching RE this year?  If so, specify which grade and level of involvement.     9. Have any of your children participated in CUUC's Religious Education program before?   Yes      No   10. Relationship with CUUC   I am (or someone in my household is) a current member of CUUC.   I am (or someone in my household is) a pledging friend of CUUC. I am planning to become a member of CUUC soon.   I am a visitor.   I am unsure of my status. Please be sure the data you have entered is accurate and then press the "submit" button to send your registration by email to the CUUC DRE.   Alternatively, you may print this form without submitting and give it to Martin Blue-Norton.

CUUC Home Page | Youth RE Page Email Martin Blue-Norton, CUUC Director of Lifespan Religious Education

Columbine Unitarian Universalist Church Serving the Southwest Denver Metro Area 6724 South Webster Street Littleton, Colorado 80128 303-972-1716