Confirmation (7th & 8th Grades) 6:30 - 8:15 pm, Wednesday Education Registration

Student Name Student Name * First Last
Student Gender *

Student Gender Male Female
Student Birthdate Student Birthdate * / MM / DD YYYY
Student Grade and School (if applicable for Fall 2023) *
Student Cell Phone Student Cell Phone * - ### - ### ####
My student would like to be in a small group with?
I can help:

I can help: Guide (2 years every Wednesday) Coordinate/call/drive/help with events
Parent (Caregiver) Name #1 Parent (Caregiver) Name #1 * First Last
Parent (Caregiver) Cell Phone #1 Parent (Caregiver) Cell Phone #1 * - ### - ### ####
Parent (Caregiver) Email #1 *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent (Caregiver) Name #2 Parent (Caregiver) Name #2 First Last
Parent (Caregiver) Cell Phone #2 Parent (Caregiver) Cell Phone #2 - ### - ### ####
Parent (Caregiver) Email #2
Do your children have any special needs or restrictions?
My child has permission to participate in any activity, games, hiking, and field trips planned for the Calvary Lutheran Education Program. I agree that the church, its personnel and volunteers and teachers will not be held responsible and hereby release them from any accidents which may occur.
THIS IS A RELEASE. I HAVE READ AND UNDERSTAND THIS RELEASE. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date * / MM / DD YYYY
Spam Protection. Please answer this simple question.
2, 14, 8, 5 : which of these is the largest?