Long Lake Lutheran Church Confirmation Registration
This form registers the youth named below in Confirmation activities during the 2022-2023 school year.   
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Email *
Child's Name *
Birthdate *
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DD
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Grade (entering this fall) *
School they will attend *
Address *
Best email for parents (for weekly email) *
Email address for student (if they have one)
Is the student Baptized? *
If the student is Baptized do you know the date?
MM
/
DD
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YYYY
Has your student gone through 1st Communion classes?
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Student Cell # (if they have one)
Insurance Carrier *
Insurance ID # *
Policy Holder Name (Usually Parent/Guardian) *
Parent/ Guardian  Information Name, Cell Phone, and Address (Please list all applicable Names, contact information and any additional addresses or email addresses we may need) *
Any special medical/learning needs/allergies that would be helpful for us to know? *
YOUTH VOLUNTEERING:  One of our expectations of youth in confirmation is that they do 15 service hours.    Some of those need to be in the life of the church.   We ask all youth to be an acolyte, and we ask every family to serve dinner at least once on Wednesday evenings.   You are welcome and encouraged to serve in other ways too!  At our Parent meeting on September 14th, we will have a sign up for meals and acolyting.   Check the boxes for other ways you are interested in serving! *
Required
YOUTH:  Please list any other special talents you might like to share in church
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 any way you would want to volunteer for on a one time or regular basis *
Required
PHOTO RELEASE -   I hereby certify that I am the legal parent or guardian of the student on this form and do herbey 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 and social media (including the church website) *
We like to support our youth in their activities outside of church!   What other activities is this student involved in? *
PARENT AUTHORIZATION:  This permission form is correct, and the person escribed can engage in all youth activities associated with Confirmation ministry.   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 ( including to hospitalize, to order injections, anesthesia or surgery)the child that is named above. *
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