Confirmation Class Registration Form

Please fill out the below form to enroll your child in Emanuel Lutheran Church’s Confirmation Class for this school year. Once you complete the form please click the Submit button and the form will be sent to Pastor Amanda as well as to the Church Office for processing.

If you prefer please download a copy of the form here and submit it to the office

Student's Name (Required Field) *

Street Address (Required Field) *

City/State/Zip (Required Field) *

Home Phone Number: (Required Field) *

Student's Cell Phone Number: (If Applicable)

Student's Email Address (If Applicable)

Student's Date of Birth (Required Field) *

Grade in School during this School Year: (Required Field) *

Known Allergies/Special Needs:

Parent's Name (Required Field) *

Parent's Cell Phone Number (Required Field) *

Parent's Email Address (Required Field) *

Parent's Name (If Applicable)

Parent's Cell Phone Number (If Applicable)

Parent's Email Address (If Applicable)

Emmanuel Lutheran Church Website Photo Permission: (Required Field) *

Permission to use picture on Emmanuel Lutheran's website

Emmanuel Lutheran Church Facebook Page: (Required Field) *

Permission to use picture on Emmanuel Lutheran's Facebook site

Parent/Guardian's Name Who is Giving Permission (Typing in your name will serve as your signature) (Required Field)

Parent/Guardian's Email (Required Field) *

Date Signed (Required Field) *

Name