Confirmation Registration 2019/2020
Register for Confirmation 2019 - 2020! All Ministry Kick - Off is September 4. Confirmation begins September 11, 2019!
Youth First Name *
Your answer
Youth Middle Name *
Your answer
Youth Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Grade 2019/2020 School Year *
Required
School *
Your answer
Home Phone Number *
Your answer
Youth Cell Number *
Your answer
Can Youth Receive Texts at this Number? *
Mother's Name *
Your answer
Mother's Email Address *
Your answer
Mother's Phone Number *
Your answer
Mother's Cell Number *
Your answer
Can You Receive Texts at this Number? *
Father's Name *
Your answer
Father's Email Address *
Your answer
Father's Phone Number *
Your answer
Father's Cell Number *
Your answer
Can You Receive Texts at this Number *
Volunteer Options - Check all that apply *
Required
Consent to Treat: The parent or legal guardian understands that all efforts will be made to contact the parent or legal guardian prior to treatment. In the event that a parent or legal guardian cannot be reached in an emergency, the parent or legal guardian gives permission to the activity leader to make the decisions necessary for treatment. Should there be no activity leader available, the parent or legal guardian gives permission to the attending physician to treat the minor child. The parent or legal guardian of the minor participant consents to any x-ray, anesthetic, medical, surgical, or dental diagnosis or treatment that may be deemed necessary for the minor child. *
Photo, Press, Audio, and Electronic Media Release Form: The parent or legal guardian grants permission to First St. Paul's Lutheran Church to use, including public display, or show the participant’s photograph, video, or audio clip on the website or in any other official First St. Paul's publications without further notice. The parent or legal guardian consents that such photographs, films, recordings, and tapes are the property of First St. Paul's Lutheran Church, and they shall have the right to duplicate, reproduce, crop, edit or treat the photograph, video, or audio clip as they may desire free and clear of any claim whatsoever on the part of the parent or legal guardian. *
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