Member Information

Member information is crucial for ensuring we are able to stay in touch.

Please complete one form for each adult member.

In addition to the Member Information form, please complete the Member Interest Form so that we can help you get connected to the Live Oak community.

This address will receive a confirmation email

Member Information

First and Last Name

Your Pronouns

She/Her/Hers He/Him/His They/Them/Theirs Ze/Hir/Hirs Other/no pronouns (please share below)

Other Pronouns

Mobile Phone

Home Phone

Name of spouse(s)/partner(s) sharing your home

All minor children (first and last names) and their birthdays

Street Address, City & Zip

Mailing Address

Birthday

In Case of Emergency

If we are together at a Live Oak UU function and something happens to you, please help us know what to do.

We want to make sure we can best serve your needs and your wishes in the event of an emergency.

Emergency Information will be available only to the Pastoral Care and Safety Teams. The Medical Power of Attorney information will be kept by Rev. Joanna.

Emergency Contact First and Last Name

Emergency Contact Phone Number

Emergency Contact Relation

Medical POA Contact Name (if applicable)

Medical POA Contact Phone Number (if applicable)

Where is the Medical POA document kept? (if applicable)

Pertinent Medical Information about yourself and/or your children in case of emergency

Description

We are so glad you are a member of Live Oak Unitarian Universalist Church.
Please complete one form for each adult member in your household.
You can update this form at any time.

Member Information

Description

Please Fix the Following