Confirmation Registration Form

Confirmation 2022-23 Registration Form

Fill out all sections of the form. Please only leave blank what you do not know or does not apply to your family/child.
Student Name

First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
Baptismal Date

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
School attending:
Grade
Mobile Number

Media release:

Do you, as the parent or legal guardian of this child, grant Our Savior Lutheran Church (Minot) permission to use photographs and videos of your child in various printed materials, publicity, illustrations, advertising, and web content?
Do you agree to the above media release, using this submission as your electronic signature?

I hereby give permission to Our Savior Lutheran Church to use the image of the child registered above. No.
Should be Empty:

Confirmation 2022-23 Registration Form