2019 Parent's Morning Out - CONVERGE
EPICenter | June 26 | 9am-noon

AGES 5 - 5th GRADE

STEP 1: Please COMPLETE all information.  Use one registration form per family.

PARENT/GUARDIAN INFO
**used for communication and confirmation emails - check for typos**


1st CHILD INFO

PHOTO/VIDEO RELEASE
For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



2nd CHILD INFO
*Please put NONE if does not apply.

PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



3rd CHILD INFO
*Please put NONE if does not apply.

PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



4th CHILD INFO
*Please put NONE if does not apply.

PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



5th CHILD INFO
*Please put NONE if does not apply.

PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

  • I have read and understand the above information. The information I have given UCUMC/EPIC is complete, accurate and true to the best of my knowledge.
  • My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.

 



When this form is processed, you will receive a confirmation email. Thank you!