Director of Religious Ed. Pam Baxter
CONFIDENTIAL 2008-09 Registration Form Unitarian Fellowship of West Chester Religious Education Program
Child First Name: Child Last Name: Child Age: Child Current School Grade: Year Child will Graduate High School: Address:
Your First Name: Your Last Name: Your Relationship to the Child: Spouse/Partner Name (if applicable): Daytime Phone: Evening Phone: Cell Phone: Your Email (Required):
List any talents or interests your child might like to share (eg., singing, acting , reading, musical instruments):
1. Does your child have any special dietary restrictions? Yes No If YES, please describe:
2. Does your child have any allergies or medical issues we should be aware of? Yes No If YES, please describe:
3. Does your child have any physical limitations/disability that would prevent him/her from using the stairs that provide access to the RE classroom space? Yes No
4. Does your child have special needs that affect his or her ability to participate in a classroom setting? Yes No Note: If you answered “yes” to either of the above two questions, you must fill out the SPECIAL NEEDS section below and speak with the Director of Religious Education to talk about your child’s specific needs and if we can accommodate your child.
5. The Religious Education program at UFWC is a parent cooperative. Without the participation of our families, we could not offer a quality program! We count on Volunteer help in the following areas -- please indicate where you might be able to assist. Yes No Classroom Aide Yes No Group Activity Aide Yes No Assist with Special Event Yes No Help in the Nursery Yes No Teach an RE Class Yes No Serve on the RE Committee
6. We ask non-teaching parents of RE students to volunteer on a rotating basis as “Floating Volunteer.” Being the “FV” is easy and fun, and helps everything run smoothly on Sunday mornings. It’s also a great way for you to stay in touch with what’s going on. Printed instructions are posted in the snack area and in the RE section of our website. You may also contact the DRE or anyone on the RE Committee for more information.
(Required) I understand that one of my (occasional) responsibilities is to be the Floating Volunteer.
7. Is there anything else you feel we should know about your child in order to help him/her have a positive experience at UFWC? If so please describe below:
PERMISSIONS:
Field Trips: I hereby give my permission for my child, named above, to participate in Field Trips (walking, within 4 blocks of the Fellowship) or to travel by car driven by UFWC parents &/or teachers. Prior notification will be given for field trips involving car travel.
Yes No Photos: I hereby give my permission for photos of RE activities that include my child, named above, to be posted to the UFWC website and/or appear in Connections, the weekly Fellowship email update. I understand that children’s names will not be listed.
SPECIAL NEEDS
If you answered “Yes” to either/both questions 3 and 4 above, please complete this section. Otherwise, proceed to the bottom to submit the information.
Thank you!
1. Please describe your child’s special needs (or provide any applicable diagnoses):
2. If your child has a physical disability, please describe his or her specific requirements for access to the RE space:
3. If applicable, at what grade level is your child currently working? (Pre-school, Kindergarten, 1st Grade, etc.):
4. Is your child able to participate in group activities with typical children his or her age?
5. What situations or activities are especially difficult for your child?
6. What supports, strategies, or approaches have been useful in helping your child to learn or participate in group activities?
7. Does your child require individualized adult support in a classroom setting?
8. If yes, please indicate the support you will provide (i.e. family member, Therapeutic Staff Support (TSS), or other aide) during RE classes with your child: NOTE: If a support person or other aide is not available for any session, you will be expected to attend the session with your child.
If you have further information that you would like to share, please include it here:
I understand that the information provided on this form will be reviewed at the beginning of each school year, and on an as-needed basis to determine whether my child’s developmental or physical changes require changes to the plan, if any, developed to assist my child. I understand that the information on this form will be provided to my child’s RE teachers on an as-needed basis. I also understand that the Unitarian Fellowship of West Chester will try to accommodate the special needs of my child, but is under no obligation to continue to do so if my child’s developmental or physical changes are of such a nature as to be disruptive to the RE Program and/or to the well-being of the other participants in the Program.
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