St. Paul Confirmation Registration 2022-2023

St. Paul Confirmation Registration 2022-2023

Must be in the 9th grade or above 2022-2023 school year.
Before registering for Confirmation preparation please review this Confirmation Candidate Commitment form and discern if you and your child are committed to accepting the guidelines for receiving this sacrament (click back to return to registration form),

https://docs.google.com/document/d/1vfX9GomR77ogrZmnMifzxLYEbk3mOVbXH-jUJniQFcE/edit?usp=sharing
Name of student

First Name Last Name
Gender

Male Female
Date of Birth *

Month Day Year
Date
TEEN/YOUTH Cell Phone Number
Teen Email (should NOT be a school email account, may use a parent account)
example@example.com
Can I text or email your child for Confirmation purposes?

Yes No
School currently attending. If homeschooling, please write that in *
Grade in school

9th Grade 10th Grade 11th Grade 12th Grade
Is your Child baptized?

Yes No
In order to receive Confirmation, the diocese requires a recent (within 6 months of receiving the sacrament) certified baptismal certificate from the church of baptism. If you would like me to request this for you please provide below: date of baptism, church of baptism, city and state.
In order to improve communication and ensure that you are well informed, please respond below with the phone number and email that you use most often and will check regularly. Thank you!
Father/Guardian Name
Name

First Name Last Name
Religion
Occupation
Father/Guardian Phone Number
Father/Guardian Email
example@example.com
Mother/Guardian Name
Name

First Name Last Name
Religion
Occupation
Mother/Guardian Phone Number
Mother/Guardian Email
example@example.com
Teen resides with (please choose appropriate response)

Both parents Mother Father
Address of child's residence

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Check below the sacraments your child has received
(Confession)

Baptism Reconcilation First Communion
Any other information you would like to share?
WAIVER: As the parent or guardian of this child, I authorize participation in St. Paul's Confirmation program. I assume all risks and hazards incidental to such participation both during an activity and en route and do hereby release and waive all claims against the Diocese of Pensacola -Tallahassee and St. Paul Church Parish, its staff, volunteers and participants. I also grant permission for emergency first aid to be given in case of injury and transportation to the hospital, if necessary. I have read and agree to the waiver above. Please sign your name electronically below.
Electronic Signature Waive

I accept
By selecting the "I Accept" box above, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.
It is the promise and commitment of the Diocese of Pensacola-Tallahassee to use pictures and videos from Diocesan and/or parish youth events in a dignified and respectful manner.

I hereby authorize the Diocese of Pensacola-Tallahassee, including its parishes, schools, and institutions (hereinafter referred to as “Diocese of Pensacola-Tallahassee”) to use, prepare, reproduce, record, video tape, publish, distribute, broadcast, electronically store, and exhibit my name, image, portrait, likeness, words, and/or voice in connection with interviews, sessions, or events conducted, sponsored, or arranged by the Diocese of Pensacola-Tallahassee and its employees, volunteers, and agents. I acknowledge that any notes, photographs, motion pictures, digital images, recordings, or other media format taken of me will become the property of the Diocese of Pensacola-Tallahassee, and I specifically waive any right to compensation for the foregoing. I understand that my likeness, name, image, or voice may be used by the Diocese of Pensacola-Tallahassee without limitation for any professional purpose, now or in the future, and I consent to the same. This permission extends to any authorized print or broadcast media organization that may participate in such preparation, use, reproduction, publication, or distribution.

I release the Diocese of Pensacola-Tallahassee and its employees, volunteers, agents, and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. I also hereby waive any right I may have to inspect and approve in advance the photographs, videos, sound recordings, or publications or media in which I am included. I agree to release the Diocese of Pensacola Tallahassee and its employees,
In regard to the media release above:

I agree to it. I do not agree to it.
Payment Information

Fee for Confirmation Preparation is $50. Payment due August 1, 2022. If you are in need of financial assistance please contact Debbie Ridder, ridderd@stpaulcatholic.net. You will receive information for sending payment or paying online once you submit this completed form. Thank you!
Should be Empty:

St. Paul Confirmation Registration 2022-2023

Father/Guardian Name

Mother/Guardian Name

Payment Information