Confirmation Registration 2019-2020
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Please fill out all applicable information and "submit" when finished.
Youth's Name (First, Middle, and Last) *
Youth's birth date
Youth's grade
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Youth's Age
Primary Home Address
Home Phone Number
Youth's Cell Phone Number
Home email address
Mother's Name
Mother's Address
Mother's Phone Number
Mother's Email Address
Father's Name
Father's Address
Father's Phone Number
Father's Email Address
Medical Information or allergies teacher should be aware of?
Comments or concerns teacher should be aware of?
I give permission for photos of my family to be used in literature and/or presentations of Christus Lutheran Church.
I grant permission for my child to attend offsite events during the Confirmation time, for example: scavenger hunts, service projects, etc.  I hereby release Christus Lutheran Church staff and volunteers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my son or daughter’s involvement.  In the event that I am unable to be reached in an emergency, I give permission to Christus Lutheran Church staff and volunteers to administer general first aid treatment or to summon any and all professional emergency personnel to attend, transport, and treat my child as deemed necessary by a licensed physician.
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