Confirmation Preparation Registration
2024-2025 School Year
This program is for students who attend private, Catholic schools and are receiving religious instruction as part of the curriculum. This is not for students currently attending Incarnate Word Parish School or the PSR program.
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Email *
Student Name (First, Middle, Last) *
Date of Birth *
MM
/
DD
/
YYYY
Address (street, city & zip) *
Full Time School 2024-2025 *
Grade *
Sex *
Has your child previously attended religious education classes? How many years? Where? *
Father (First, Last) *
Father's Religion *
Father's Occupation *
Status *
Father - Cell *
Father - Email *
Mother (First Name, Maiden Name) *
Mother's Religion *
Mother's Occupation *
Status (Married, Separated, Divorced, Remarried, Widowed) *
Mother - Cell
Mother - Email
Step-Father (First/Last Name, Religion)
Step-Mother (First/Last Name, Religion)
Is your family registered in Incarnate Word Parish? *
Required
If no, where are you registered?
Do you have a letter from the pastor of that parish delegating responsibility for the student's sacramental preparation to Incarnate Word? If yes, please forward a copy to the parish office.
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Student Sacrament Information: Baptism (include date, church name & address).  If at a church other than Incarnate Word, please send in a copy of the baptismal certificate) *
Student Sacrament Information: First Communion (include date, church name & address) *
Emergency Information: Physician's Name, Address, Office Phone/Exchange; Hospital in case of emergency *
Name two neighbors or relatives who will assume temporary care of your child if you cannot be reached (Name/Address/Phone #) *
Doe your child receive any Special Services at their school or after hours? *
Please note any special medical needs, allergies (food, medications, etc.) or medications: *
Photo Release: I hereby authorize the use of photos and video taken of my child during Confirmation be allowed for promotional purposes on Incarnate Word's website and other promotional materials published by Incarnate Word.
 *
A copy of your responses will be emailed to the address you provided.
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