Saint Timothy Adult Confirmation Registration Form

Saint Timothy Adult Confirmation Registration Form
Program Information & Acknowledgment
Adult Confirmation will be celebrated on Pentecost Sunday, June 8th, 2025 at the 11am Mass.

Candidates must complete all registration paperwork and submit copies of Baptism and First Eucharist certificates by March 1st, 2025.

There will be an introductory meeting on Wednesday, March 19th, 2025 from 7-9pm in the Fireside Room (on the second floor above the front office).

Candidates will also choose a Saint whose name they wish to be confirmed under.

Candidates and Sponsors are expected to attend Mass every week.

Candidates and their Sponsors will complete the preparation together. Preparation will be on Wednesday evenings from 7-9pm on Wednesdays, April 23rd, April 30th, May 7th, May 14th, May 21st, May 28th & June 4th, 2025 in the Fireside Room.

All questions can be directed to Matt Zemanek, Director of Adult Evangelization & Faith Formation: 949-973-9025, mzemanek@st-timsrc.org.
I have read the requirements above and I understand and agree to complete everything above as part of this preparation process:*

I agree
Personal Information

All information on this form is held in confidence and is only used or shared with those on staff or the Adult Confirmation team for communication and canonical purposes only.
Name*

First NameLast Name
Cell Number*
Please enter a valid phone number.
Other Phone
Please enter a valid phone number.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Upload a recent photo of you so our team can better recognize you (optional):

Cancelof
Sacramental Information
Marital Status*

Single (unmarried)MarriedDivorced and not remarriedDivorced and remarriedWidowed
Are you currently married in the Catholic Church?*

YesNoI am not married
If married, have you or your spouse been married before?*

I am not marriedNo, this is our only marriageYes, I have been married beforeYes, my spouse has been married beforeYes, we have both been married previously
At what Church were you Baptized?*
Location of Church of Baptism*
In the US: City & State; International: City, State/Region (if applicable) & Country
Date of Baptism

MonthDayYear
Date
I will provide a copy of my Baptismal certificate*

Now (please upload below)Later (note: this should be done by March 1st)
Copy of Baptismal Certificate

Cancelof
At what Church did you receive your First Eucharist?*
Date of First Eucharist

MonthDayYear
Date
Location of Church of First Eucharist*
In the US: City & State; International: City, State/Region (if applicable) & Country
I will provide a copy of my First Eucharist certificate*

Now (please upload below)Later (note: this should be done by March 1st)
Copy of First Eucharist Certificate

Cancelof
What do you hope to gain by receiving the Sacrament of Confirmation?*
What topics, teachings, or areas of Catholic belief and practice would you like to learn more about? *
Sponsor Information

This person must be an active, Confirmed Catholic in good standing who is not your parent/legal guardian, not your current or future spouse, and if they are married they must be married in the Church.
Do you have a Confirmation Sponsor in mind?*

YesNo
Sponsor Name*

First NameLast Name
Sponsor cell phone*
Please enter a valid phone number.
Sponsor other phone*
Please enter a valid phone number.
Sponsor e-mail*
example@example.com
Sponsor's address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is the name of your Sponsor's parish? (Sponsors will need to verify their involvement by having a form signed by their parish unless they attend Saint Timothy's and are registered as active in our system)*
What is your Sponsor's relationship to you?*
We can help find a sponsor for you from our parish. These questions will help us to find a sponsor that best matches your needs, personality, and background. Please feel free to disclose as much or as little as you think would be relevant for us to know and that you are comfortable sharing.
What is your educational background and/or area(s) of study?:*
Favorite Hobbies/Pastimes?:*
What is your spiritual background and experience with faith in general?:*
What would you be looking or hoping for from a Confirmation Sponsor?:*
Do you want a Sponsor who is similar to you or very different? Why?*
Is there any other information about your personal history or family life that might be relevant or helpful for us to know?:*
Emergency Information
Medical Insurance Company:*
Your Policy Number:*
Group Number:
Primary Physician's Name:*
Primary Physician's Phone Number:
Please enter a valid phone number.
Allergies:*
Dietary Restrictions:*
Medical Conditions or Disabilities:*
Any other health related information or history we should be aware of in case of an emergency?:*
Emergency Contact:*

First NameLast Name
What is their relationship to you?:*
Emergency Contact phone number:*
GENERAL LIABILITY & PHOTO RELEASE

I, {name}, consent to participate in this parish program and all related events. This activity will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from St. Timothy Catholic Church.

I am aware of the Technology Guidelines for the Diocese of Orange, including the Codes of Conduct & Policy Against Sexual Misconduct.

I authorize and consent to staff or other leaders of the parish to communicate with me electronically, including via social media, text, email, phone and video conferencing tools (e.g. Zoom) in accordance with the program(s).

I remain legally responsible for any personal actions taken by myself. I agree on behalf of myself, my heirs, successors, and assigns, to hold harmless and defend St. Timothy Catholic Church, its officers, directors, employees, and agents, and the Diocese of Orange, its employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with my participation in this program or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith.

I agree to compensate the parish/school, its officers, directors, and agents, and the Diocese of Orange, its employees, agents, chaperones, or representatives associated with the event for reasonable attorney's fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/school or the Diocese of Orange.

I authorize the making of photographs, motion pictures, video tapes, recordings, or other memorializing of said event(s) and my participation therein, and the publication and duplication or other use thereof. I waive any rights to compensation or any right that I otherwise might have to limit or control such making or use.

I give permission to the physician, nurse, dentist, or licensed care staff selected by the supervisory personnel then present to render medical, dental, or other appropriate treatment deemed necessary and appropriate by the physician, nurse, dentist, or licensed care staff.

COVID-19 PASSIVE SCREENING

I agree to check my own temperature before coming to the parish to ensure it is below 100.4 degrees Fahrenheit, observe for symptoms outlined by public health officials, and stay at home if symptoms are present consistent with COVID-19 or close contact with a person diagnosed with COVID-19 has occurred. When on campus, I agree to wash and sanitize my hands upon entering campus.
Signature*

Clear
And Finally...
Do you have any questions, concerns, comments or prayer requests?*
Should be Empty:

Saint Timothy Adult Confirmation Registration Form

Program Information & Acknowledgment

Personal Information

Sacramental Information

Sponsor Information

We can help find a sponsor for you from our parish. These questions will help us to find a sponsor that best matches your needs, personality, and background. Please feel free to disclose as much or as little as you think would be relevant for us to know and that you are comfortable sharing.

Emergency Information

GENERAL LIABILITY & PHOTO RELEASE

COVID-19 PASSIVE SCREENING

And Finally...