Youth Confirmation Registration Form


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Youth Confirmation Registration Form Please complete the following information form and return it to the Church Office. This form can be returned by mail, fax, email, or in person at the Church. Please print legibly.

Full Baptismal Name: _________________________________________________________________ (Nickname/preferred name): ____________________________________________________________ Date of Birth: ________________________ Place of Birth: ___________________________________ Date of Baptism:______________________ Place of Baptism:_________________________________ Denomination of where Baptism took place:________________________________________________ Learning disability ____Yes ____No If yes please describe:______________________________________________________ Food allergies:________________________________________________________________________ Student’s email address (for office use only) :_______________________________________________ Student’s cell phone (for office use only): __________________________________________________ Full Name(s) of Parent(s)/Guardian(s): ____________________________________________________ Home address: _______________________________________________________________________ Home phone: ___________________________ Cell phone: __________________________________ Email address(es): ____________________________________________________________________ Name of Mentor/Godparent (if known): ___________________________________________________

Are you and your family registered members of St. Peter's? ____Yes ____No If no, would you like to become members? ____Yes ____No If yes, please fill out the attached new member form.

Other important information you would like us to know to support your child and family: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________