9th Grade Confirmation Registration

9th Grade Confirmation

* Indicates required field

Student Name *

First

Last

I prefer to be called: *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Student Cell Number *

with Text *

Yes No

Student Home Phone Number *

Student Email *

Best time to contact me is *

Cell Phone Home Phone Email

Birthdate *

Baptism Date *

Hawley Lutheran Church Member *

Yes No

Mother's Name *

First

Last

Mother's Cell Number *

with Texting *

Yes No

Home Phone Number *

Mother's Email *

Best time to contact me is *

Cell Phone Home Phone Email

Father's Name *

First

Last

Father's Cell Number *

with Texting *

Yes No

Home Phone Number *

Father's Email *

Best time to contact me is *

Cell Phone Home Phone Email

List any other experiences you have had working with children/youth. *

Have you worked with children/youth at another church? *

Yes No

Name/City of church you have worked with children/youth *

Permission for *

I give my child/youth permission to attend offsite Confirmation Servant Events (TBD). I do NOT give my child/youth permission to attend offsite Confirmation Servant Events (TBD). I give permission for pictures of my child/youth to be on the church website/Facebook. I do NOT give permission for pictures of my child/youth to be on the church website/Facebook.

Today's Date *

Submit