Confirmation Registration-Zoom Class

ALC Confirmation Registration-Zoom Class

Date: Sundays Time:11:00 am
How many confirmads/children are you registering?*
Attendance Preference
How will your child(ern) attend confirmation class? *
In-person or Zoom/ Virtual
Zoom/Virtual option will require a home computer and internet access.
Child Information
First Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child*
Second Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child*
Third Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child*
Fourth Child
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Last Grade Completed*
Medical or other information we may need to know about the child*
Child Information
Parents/Legal Guardian Name*

First NameLast Name
Parents/Legal Guardian Name*

First NameLast Name
Best Contact Phone Number*

Area CodePhone Number
Email Contact*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
In-Person Attendance Information Only

Not applicable for Zoom attenders
Names of Person(s) bringing child(ren) to church (if other than parent/guardian)

First NameLast Name
Full Name

First NameLast Name
Full Name

First NameLast Name
Name of Adults allowed to pick up child(ren) (fifth grade and below:
Emergency Information
Emergency Contact 1*

First NameLast Name
Emergency Contact 1 Phone Number*

Area CodePhone Number
Media Release
I consentI do not consent
Signature

Clear
Should be Empty:

ALC Confirmation Registration-Zoom Class

Attendance Preference

Child Information

First Child

Second Child

Third Child

Fourth Child

Child Information

In-Person Attendance Information Only

Emergency Information

Media Release