Confirmation Registration

Student Information

Student's Name

Student's Preferred Name

Student's Pronouns

Student's Birthdate

Student's Grade

6th 7th 8th

Student's Phone

Student's Email

Student's Address

List any Medical Concerns, Allergies, ETC.

Household Information

Parent/Guardian 1 Name

1 Cell Phone

1 Email

1 Address

Parent/Guardian 2 Name

2 Cell Phone

2 Address

2 Email

Photo/Video Release

I DO / DO NOT allow any photos or videos of my child/children to be taken during Trinity events for media or publication (newsletter, website, power point, etc.).

DO DO NOT

Release of Liability

In exchange for participate in the activities and events organized by Trinity Lutheran Church, I agree for myself and (if applicable) for the members of my family to the following. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge Trinity Lutheran Church for injury, loss or damage arising out of my or my family’s use of or presence upon the activity/event fore-mentioned, whether caused by myself, my family, Trinity Lutheran Church or other third parties. PLEASE TYPE YOUR NAME WHICH WILL COUNT AS A SIGNITURE.

Description

Parents/Guardians please fill out this form for each child attending confirmation class at Trinity Lutheran Church. This form helps us keep in contact with you. Each year we will ask for this form to be filled out.

If you have any questions please reach out to me at dbarbeau@tlcwaupaca.org .

Thank you!
Delaney Barbeau

Confirmation Registration

Description

Please Fix the Following