2019-2020 Confirmation Registration
Grace Lutheran Church 300 South Grant Fairmont MN 56031
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Student's Name *
Student's Birthday? *
Graduating Class *
Has this student been baptized? *
Has this student has First Communion? *
Parent/Guardian Name *
Address *
Parent's Phone Number *
Parent's Email *
Name of other Parent/Guardian
Address for other Parent/Guardian if different than child's address
Phone number for other Parent/Guardian
Other Parent/Guardian's email
Student's Phone Number.  If student has no phone please enter parent's phone number. *
Student's email. *
Name of Emergency Contact (other than Parent/Guardian) *
Emergency Contact Phone Number *
Relationship of Emergency Contact with your child? *
Mentors
Mentoring is a longstanding tradition at Grace.   During Advent and Lent students and mentors worship together on Wednesday nights at 6:30 and take time afterwards for conversation.  We ask that each child has their own mentor, who is not one of their parents to meet with over 3 years.   Mentors are chosen, ideally, by parents/guardians together with their child?
Who would you choose as a good potential mentor for your child? *
If this person is unavailable who else would you choose as a mentor for your child? *
Potential Parent Involvement?  Please check all areas of interest. *
Required
Is there anything we should know to ensure the best possible experience for your child?   Please share medical conditions including allergies, vision/hearing concerns, physical limitations, learning disabilities or relevant information about your child. *
Group Conduct Expectations
All students are expected to act in respectful and responsible manner while they are part of Grace's confirmation program.  Parents will be contacted about any concerns that arise.
All students are expected to: Check in at Appointed Times.  Respect property.  Respect one another, staff and leaders.  Respect and comply with event schedules.  Remain in designated areas for class/events/worship.  Behave honorably and respectfully in worship. No offensive or immodest clothing.  No possession or use of alcohol, drugs, vaping devices or tobacco.  No fighting, weapons, lighters or explosives. *
Permission and Release for Medical Treatment
My child has permission to take part in all congregational activities including off-site events? *
In case of emergency, I understand that effort will be made to contact me. If I cannot be reached, this document gives permission to Grace Lutheran Church, its staff, chaperones and supervisory personnel to act on my behalf in seeking emergency treatment for my child. I give permission to those administering emergency treatment to do so using measures deemed necessary, and I agree that the congregation, its staff, chaperones and off-site personnel will not be held responsible for accidents or liabilities which may occur.  I accept responsibility for all costs related to emergency medical treatment. *
I give Grace Lutheran Church permission to photograph and/or video record my child.  I further give permission to use photos or video for publicity or other purposes including, but not limited to newsletters, church publications, public media publication and/or the internet including the church website. *
By checking this box and typing your name you are stating in below you are stating that you are authorized to make decisions for the child listed above.  Your digital signature on this form will be treated as a written signature.  Thank you. *
Please type in your full name and date. *
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