Confirmation Info Form for Parent or Guardian

All information shared here will remain confidential and will be used only when the child is engaged in activities at/through St. Luke.

"*" indicates required fields

Teen's Name*
Mailing Address*
Names of parents/guardians and relationship to child:*
Click the + icon on the righthand side to add multiple names.
Full Name
Relationship
 
Name of contact, where will the person normally be, and best phone number to use.
Who may pick your child up from confirmation?*
Teens will not be allowed to leave until an adult is visible to the leaders. Click the + icon on the righthand side to add multiple names.
MM slash DD slash YYYY
MM slash DD slash YYYY

Any allergies or medical conditions?

This enables us to provide safe snacks and activities.

Say a little something about your teen.

What do they like to be called? What are their special interests and hobbies? What sports do they play? After school activities? Gifts that we should encourage? Challenges we might address?

Permission for social media, etc.

Do you give permission to St. Luke to post pictures of this teen? Full name will never be used, non-group photos will never be full-face, and no name will be attached to on-line pictures. Please check options listed below.
Facebook or other social media (name it below), e-mail (write it below), snail mail (write it below), church bulletin board, bulletin announcements, phone (write it below), text (write it below), other (specify below).
This field is for validation purposes and should be left unchanged.