Vagabond Theater Registration

Use this form to register your child(ren) for the Vagabond Theater (8-17 year olds)

October - December

1st, 2nd, 3rd Sundays 11:15 - 12:45

10/5, 10/12, 10/19

11/2, 11/9, 11/16

12/7, 12/14, 12/21

Parent/Guardian #1

Guardian #1 email

This address will receive a confirmation email

Guardian #1 Address

Guardian #1 Cell Phone

Parent / Guardian #2 Name

Guardian # 2 Email

This address will receive a confirmation email

Guardian # 2 Cell Phone

Guardian #2 Address (if different)

Child #1 Information

Name

Age

Birth Date

Notes (Please include any allergies, dietary or learning needs, and/or any other information that will help us make our church a safe space for your child.)

Child #2 Information

Name

Age

Birth Date

Notes (Please include any allergies, dietary or learning needs, and/or any other information that will help us make our church a safe space for your child.)

Child #3 Information

Name

Age

Birth Date

Notes (Please include any allergies, dietary or learning needs, and/or any other information that will help us make our church a safe space for your child.)

Name

Age

Birth Date

Notes (Please include any allergies, dietary or learning needs, and/or any other information that will help us make our church a safe space for your child.)

Photo/Video Release

I understand that the Unitarian Universalist Church of Concord takes posed group photos, videos, and candid photos to illustrate the life of our church. I authorize the UU Church of Concord to use and publish photos of my child(ren) in print and/or electronically. I agree that the UU Church may use such images of my child(ren) without names and for any lawful purpose, including for example such purposes as publicity, illustration, and web page content. I understand that if the church wishes to name my child in any photo for publication, I will be consulted first.

I authorize Concord UU to publish photos of my child(ren):

Yes No

Description

Use this form to register for the Vagabond Theater. If you have any questions, please contact Dory LeCount, at dory@concorduu.org

Vagabond Theater Registration

Description

Please Fix the Following