2020 Confirmation Registration

School Year 2020/2021
Grades 6, 7, 8 and 9. Registration Fee: $50 per child.

FAMILY INFORMATION
Parent/Guardian #1 Name:
Parent/Guardian #1 Cell: - (###) - ### ####
Parent/Guardian #1 Email
Parent/Guardian #2 Name:
Parent/Guardian #2
Cell: - (###) - ### ####
Parent/Guardian #2 Email
Home Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
YOUTH(S) INFORMATION
Youth #1 Name * First Last
Youth #1 Birth Date * / MM / DD YYYY
Youth # 1 Grade in School: *
Youth #1 TYPE OF STUDY * Online Only Online & On-site (when allowed)
Youth #1 Allergies, special needs, medical conditions, etc.:
Youth #2 Name First Last
Youth #2 Birth Date / MM / DD YYYY
Youth # 2 Grade in School:
Youth #2 TYPE OF STUDY Online Only Online & On-site (when allowed)
Youth #2
Allergies, special needs, medical conditions, etc.:
Youth #3 Name First Last
Youth #3 Birth Date / MM / DD YYYY
Youth # 3 Grade in School:
Youth #3
Allergies, special needs, medical conditions, etc.:
Youth #3 TYPE OF STUDY Online Only Online & On-site (when allowed)
EMERGENCY INFORMATION
Emergency Contact person (other than parent) * First Last
Relationship to child(ren):
Emergency Contact Phone * - (###) - ### ####
Acknowledgements, Permissions & Medical Release
* I give Family of Christ Lutheran Church permission to photography and/or video of my youth(s) while participating in church activities, and use photos/videos for promoting Family of Christ programs. I agree to release all liability from Family of Christ Luterhan Church (staff, members and volunteers) if my child(s) are injured in any way during church activities. I grant permission to Family of Christ Lutheran Church personnel to seek emergency medical treatment for my child(s) should it be needed. I understand they will make every reasonable effort to contact me or the emergency contact I provide on this form.
SIGNATURE * By checking this box I agree to the above and therefore am signing this form
REGISTRAION FEE:
Fee is $50 per Youth to be paid to the office with check or cash. You will be directed to the online giving to use credit card.

2020 Confirmation Registration

2020 Confirmation Registration

FAMILY INFORMATION

YOUTH(S) INFORMATION

EMERGENCY INFORMATION

Acknowledgements, Permissions & Medical Release