2017-2018 Confirmation Registration
Wednesdays 6:30-8:00 pm
Orientation is on September 13, Classes begin September 20
Youth's Name
Your answer
Address
Your answer
City
Your answer
Zip Code
Your answer
Grade
Your answer
Age
Your answer
Birthday
MM
/
DD
/
YYYY
Will your child be attending the confirmation retreat on September 15-16 at Camp St. Croix? (8 pm on Friday - 5 pm on Saturday)
What school does your child attend?
Your answer
Youth's Cell Phone Number
Your answer
Interests / Hobbies
Your answer
Special Needs / Allergies
Your answer
Parent / Guardian Name
Your answer
Home Phone
Your answer
Mobile Phone
Your answer
E-mail Address
Your answer
How would you like to be contacted?
We are also interested in:
(check all that apply)
For parents: I would like to help by:
(check all that apply)
Emergency Contact Name and Phone Number
Your answer
I give permission for the above registered child's photo to be included in church publications and the website.
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