UUCP Children's Ministry

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All participants of any age in Children's Ministry Programming are asked to provide the following information. All programming is provided free of charge.

*Families with multiple registrants, please fully complete this form for EACH participant. The additional time you spend entering will:
1) assure that each person has access to programming,
2) provide separate consent forms, and
3) greatly decrease the amount of paid UUCP staff time in processing registrations, setting up new programs, and contacting parents in case of an emergency.

If completing a form for each participant presents too great a time burden, please call Katie at 480.788.9363 and she will complete it for you.

Email *

Participant's First Name *

Last Name *

Please indicate which of the following programs you are interested in (click all that apply): *

Coming of Age (ages 12-15)

Coming of Age Mentors (adult community members)

Parents And Caregivers As Sexuality Educators (adult community members)

Monday Morning Meditation (all ages)

Navigators - scouting with UUCP (all ages)

3-4-5 zUUm (3-5 year olds)

Faithful Journeys/Sunday Coffee Hour sessions (ages 6-12)

YRUU (high school ages)

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Required

Birthdate *

YYYY

Pronouns *

Email Address(es) for UUCP Children's Ministry Updates and Communication (please separate multiple addresses with a comma) *

Phone Number(s) for UUCP Communication *

Name for Mail Sent via USPS *

Address Line 1 *

Address Line 2

City/ Town *

State *

Zip Code *

Parent Or Emergency Contact First and Last Name *

Parent Or Emergency Contact Phone Number *

I do hereby give UUCP, its assigns, licensees, and legal representatives the irrevocable right to use my own/ my child’s, picture, portrait, image, video or photograph in all forms and media and in all manners, including composite, for advertising, for publication or any other lawful purposes, and I waive any right to inspect or approve the finished product, including written copy, which may be created in connection therewith. *

Yes

A copy of your responses will be emailed to the address you provided.

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