Grace Confirmation Registration
Timing: September 2017 - May 2018 ---- All gatherings Sunday evenings 6-7:30 PM unless otherwise noted
Event Address: Cafe Grace at 501 Valley Park Dr, Libertyville IL 60048
Contact us at 847-367-7050 or gracelibertyville@gmail.com
Student Name *
Your answer
Student Date of Birth *
MM
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DD
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YYYY
Student Cell if applicable
Your answer
Parent (s) Names *
Your answer
Mother Cell #
Your answer
Father Cell #
Your answer
Home Address *
Your answer
Best Email for us to use for regular correspondence with your family *
Your answer
Allergies we should be aware of
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I understand that I will have to pay the $40 Confirmation Program Fee plus Fall retreat registration fee of $134 upon arrival at the student parent meeting on September 10th at 6 PM. *
Required
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