Confirmation 2020-2021
We are super excited about Confirmation this year which begins Sunday, September 20! All students must be registered for Confirmation. Even if they attended last year, please fill out this form.  Thank you so much!
Contact Allie Tiller with any questions.   Allie.tiller@lcm.church or 402-669-9518
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Student's Last Name *
Student's First Name *
Student's Preferred Name (If Different)
Entering Grade: *
Gender *
Street Address *
City *
State *
Zip Code *
School *
Birthdate *
MM
/
DD
/
YYYY
Student Cell Number
Do we have permission to include your student in a group text with schedule changes, information about upcoming events, encouragement and reminders?
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Photos of Students May Be Used for Promotional Purposes
Student Email
Allergies or Health Concerns *
Head of Household Name *
Head of Household Phone # *
Head of Household Email *
Spouse/Significant Other Name
Spouse/Significant Other Phone #
Spouse/Significant Other Email
Emergency Contact Name *
Emergency Contact Phone # *
Name of Person Transporting Student (if different than parent)
Phone Number of Person Transporting Student (if different than parent)
Name and Grade of School-Age Siblings: *
Has this student been baptized? *
Would you like to be contacted about joining the student ministry team? *
Would you be willing to help serve and clean up after the Wednesday night meals?   *
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