Confirmation Registration 2023-2024
This form registers the following young person for Confirmation activities during the 2023-2024 school year. This form will also serve as health care and photo permission for any activities on- or off-site with Long Lake Lutheran Church. Thank you!
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Student name  *
Address *
Street City State Zip *
Best email address for guardians  *
Email address for student
Current age and date of birth (mm/dd/yyyy) 
Baptized (Y or N) and date
1st Communion date, if applicable
Grade in school, name of school 
Student Cell #
Are you a member of LLLC? If not, would you like information about joining?
Insurance carrier and ID# 
Policy holder (usually a parent/guardian)
Parent/guardian name, address (if different), phone numbers 
Parent/guardian name, address (if different), phone numbers 
Parent/guardian name, address (if different), phone numbers 
Who lives in your house? ___________________________________________________

Parent Authorization--This permission form is correct, and the person described can engage in all youth activities. Long Lake Lutheran Church is released from any and all liability in case of accident or illness.

If I cannot be reached in the event of an EMERGENCY, I give permission to the physician or medical technician selected by Long Lake Lutheran leadership to secure proper treatment for, hospitalize, to order injection, anesthesia or surgery for my child as named on this form.

Signature & date:

Parents--You are a critical part of making this a meaningful experience for your child.  We hope you will participate in this ministry by volunteering. Please check how you would like to serve for on a one time or regular basis. 

Does this student have any special learning needs or medical or allergy concerns that would be helpful for us to know about?

Youth- One of our expectations is that you volunteer your time in the life of the church. Two ways that this is encouraged is through being an acolyte and working in the kitchen on Sunday morning. You are welcome to serve in other ways as well. Check things that interest you:

Clear selection
___Read the lessons ___Special music
Please list any special talents that you have and would like to share in church: 
Photo Release– I hereby certify that I am the legal parent or guardian of the student on this form and do hereby give my consent to Long Lake Lutheran Church to use my child’s photographs, video recordings or electronic images in any and all of its publications including social media and the church website.
Signature & date:
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