Children's Religious Education at First Unitarian Chicago

Primary Guardian Name

Phone

Child(ren)'s name(s) and age(s)

Any allergies or medical concerns we should be aware of?

Opt-in to children/youth RE email list -- one email weekly with current and upcoming programs Yes, add me to the list

Parent/guardian 2 name

Phone

Opt-in to children/youth RE email list -- one email weekly with current and upcoming programs Yes, add me to the list

Medical Release and Safety Acknowledgments

By marking "agree" below, as parent and/or guardian, I authorize the treatment of my child(ren) by a qualified and licensed medical professional in the event of a medical emergency which may endanger my child's life or cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only if I am not reached after a reasonable effort has been made to contact me.

Agree

I understand that for children fifth grade (~age 10) and under, a parent/guardian or designated responsible adult must be on the premises while children are attending a program.

Yes

I understand that for children ages 0-8, a parent/primary guardian or parent-designated guardian listed on this form (see below) must pick up children from their room unless other arrangements have been made in advance with the DLRE.

Yes

I understand that First U expects members and friends to protect themselves and our community by staying up to date on all recommended vaccinations, unless there is a medical reason this is not possible.

Yes

I agree to keep my child home if, within the past 48 hours, they have had symptoms of respiratory or gastrointestinal infections. I agree to send my child with a well-fitting mask if they have recovered from such symptoms within the past 10 days.

Yes

Additional Information and Optional Permissions

Anything else you'd like us to know? (e.g. accommodations, participation concerns/preferences)

Check here to request a meeting with the program director regarding accommodations or how we can best support your child and someone will reach out to schedule. Please reach out to me to schedule a meeting.

Permission to Photograph/Videotape: I grant permission to RE program staff or volunteers of First Unitarian to photograph or videotape my children during the normal course of religious education programs for use in promotional materials or on our website. (Names of children and youth are never shared outside the RE program without explicit permission for each case.) Yes No

Children ages 0-8 may only be picked up from their rooms by a parent/primary guardian unless otherwise specified.

You may make one-time arrangements for a different person to pick up or drop off by contacting Director of Lifespan Religious Education Elizabeth McCreless at dlre@firstuchicago.org.

If you would like to give ongoing authorization for someone else to pick up your child (e.g. a family member, regular babysitter, etc.), you may share their name and contact information and check the box below.

Name of additional parent-authorized guardian

Phone

As parent and/or guardian, I authorize the person listed above to pick up my child from First U programs on an ongoing basis Yes, please release my child to the person listed above.

With parent permission, children ages 9 and up may self-dismiss from their room to walk to meet their parents in the sanctuary or coffee hour. Please check below to indicate whether you would like to give your 9+ year old permission to self-dismiss or would prefer to pick them up from the classroom. My 9+ year old(s) have permission to self-dismiss from classrooms. I will pick up my 9+ year olds(s) from their classroom. Other (describe below)

Other:

Children's Religious Education at First Unitarian Chicago - 2024

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Children's Religious Education at First Unitarian Chicago - 2024

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