Communication Permission Form for High School Age Youth

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Email *

High School Youth ONLY- Do you give permission for UUCM staff and youth advisers to communicate directly with youth? N/A - my child is NOT participating in the High School Youth Group

*Yes, I give permission for UUCM staff and youth advisors to communicate directly with my child

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Parent/Guardian Name *

Youth Name *

Youth Cell Phone

Youth's email address

I give permission to the adult advisers of the UUCM high school youth group to communicate or interact with my child in the following way (Check all that apply): *

Facebook

Phone Call

Text message

Outside of UUCM activities/events as part of a group

Outside of UUCM activities/events in one on one conversations

Drive to/from UUCM activities

* I must be included in all communications*

Required

I want to be notified of all one on one meetings with my child *

Yes

I understand that I am responsible for making arrangements to transport my youth to and from UUCM events *

Yes

I understand that I am responsible for deciding with whom my child may ride in a car or give a ride to and for maintaining an understanding about this with my child. Specifically, I understand that neither UUCM nor the adult advisers are responsible for monitoring how my child gets to and from UUCM events *

Yes

Please include any other restrictions or concerns below:

Submit

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