Confirmation Registration
Please fill out this form and click submit.
Name of Student
*
Cell Phone (if applicable)
Email
*
This address will receive a confirmation email
May we include your student on a Group Me Text Chat? Pastor and adult guides will be part of the group
Please select all that apply.
Yes
No
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
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OK
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OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Birthday
*
Baptismal Birthday
*
Name and relationship of Baptismal Sponsors (godparents)
*
School
*
Contact Info
Parent / Guardian
*
Cell Phone
*
Please add to the Group Me Text Announcement App
*
Please select all that apply.
Yes
No
Cell Phone
Parent / Guardian
*
Please add to the Group Me Text Announcment
Please select all that apply.
Yes
No
Please share anything you feel is important for us to know. Include any health/allergy information
Submit
Description
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