Confirmation Application 2025-2026 Eng

2025-2026 10th-12th Grade Youth ONLY

YOU MUST ATTACH OR SEND IN A COPY OF BAPTISM CERTIFICATE

Full legal name of YOUTH (exactly as written on Baptism Certificate)*

Grade in School for the school year 2025-2026*

Birth Date*

Date

Home Address*

Mothers Name

Cell

Fathers Name

Cell

Best Contact Email Address

example@example.com

Church of Baptism Name Complete Mailing Address

EnglishSpanish

Please enter your initials next to the statements below that are true...

My child had no more than 3 absences for the 2024-2025 & 2025-2026 FaithFormation year.

Please enter your initials

I have registered my child in Faith Formation for the 2025-2026 year.

Please enter your initials

I will attend Mass each weekend with my child.

Please enter your initials

I have reviewed and witnessed my child sign the Candidate CommitmentForm. (below)

Please enter your initials

I understand that Confirmation Classes and Retreats are COMPLETELY SEPARATE from the regular Youth Faith Formation Classes and Retreats.

Please enter your initials

Parent Signature*

PARENTAL/GUARDIAN CONSENT FORM & LIABILITY WAIVER

Primary Contact Person*

Relationship*

Phone*

Format: (000) 000-0000.

Secondary Contact Person

Relationship

Phone

Format: (000) 000-0000.

Consent and Liability Waiver

Important! To be filled out by the Parent/Guardian for youth under 18 years of age. (If participant is 18 years of age or older, consent must be signed by the individual)

I (name of parent/guardian) grant permission for my child, (Participant's name), to participate in Sacred Heart of Jesus Catholic Community Confirmation Classes and the Retreats. This includes transportation by bus or chaperone vehicles to/from the parish.

I agree on behalf of myself, my child's other parent if known or living (name of other parent), my child name herein, or our heirs, successors, and assigns and defend the Archdiocese of Galveston-Houston, the sponsoring parish (its pastor, youth ministry leader, principal, other agents, etc or any representatives associated with the scheduled activity unless the parties involved were careless and negligent.

In signing this form, I certify that all information contained herein is true and accurate to the best of my knowledge.

My name (parent or guardian)*

Name of other parent

Signature of ParentGuardian*

YOUTH PARTICIPANT (If over the age of 18): In signing the line below I agree to abide by any/all policies and rules established for this event. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parent's expense.

Signature Youth Participant

VIDEO/PHOTOGRAPHY CONSENT

As parent/guardian, I understand that promotional pictures and videos (individual and group) will be taken during this event. I give permission for my son's/daughter's picture to be used for promotional materials (newsletter, web page, calendars, power point, video, etc in highlighting the event.

Signature of Parent/Guardian

Medical Matters

I hereby warrant to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child.

Emergency Medical Treatment

In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.

In the event of an emergency and you are unable to reach me, contact:

Emergency contact name and relationship (NOT THE PARENT)*

Emergency contact phone number*

Please enter a valid phone number.Format: (000) 000-0000.

Family Doctor Name

Family Doctor Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Medications

My child will bring all such medications, well labeled, that are necessary. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency are as follows:

My child is taking the following medication at the present time:

Medications

Dosage / Administer

Reason for taking

Initial next to ONE of the following two statements:

I hereby Grant Permission for nonprescription medication such as Tylenol Benadryl throat lozenges cough syrup etc. to be administered to my child if deemed advisable I understand that Aspirin will not be given to my son/daughter

I hereby Do Not Grant Permission for medication of any type prescription or nonprescription to be administered to my child unless the situation is life threatening and emergency treatment is required

Medical Conditions Information: (Personnel will take reasonable care to see that the following information will be held in confidence)

My son/daughter has:

SeizuresAsthmaDiabetic

Allergic reactions to the following (foods, dyes, medications, latex, etc.)

If allergic, specify severity/symptoms of allergy

YesNo

Has a medically prescribed diet?

The following physical limitations

YesNo

Date of last tetanus/diphtheria immunization

Date

You should also be aware of these special medical and/or psychological conditions of my child (e.g. depression, A.D.D., etc)

Insurance Information:

YesNo

Insurance Carrier

Name of Insured

Insurance Policy Number

Fathers Name

Father's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Mothers Name

Mother's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

In the event it comes to the attention of the chaperones associated with the activity that my child becomes ill with repeated symptoms such as headache, vomiting, sore throat, fever, diarrhea, I want to be called immediately. If this will be a long distance call, I want to be called collect (with phone charges reversed to myself). I fully understand the foregoing statements and sign this Parental/Guardian Medical Consent Waiver knowingly, freely, and willingly.

Signature of Parent/Guardian (must sign for anyone under 18 years of age)*

Candidate Commitment

(To be signed by the Candidate and one Parent/Guardian)

As a baptized Catholic, I am preparing for the reception of the Sacrament of Confirmation, by which I will be more perfectly bound to the Catholic Church and enriched with a special strength of the Holy Spirit to spread and defend the Faith as a witness of Christ.

As a candidate for Confirmation, I promise the following:

I will approach my Confirmation journey with an open mind and an open heart.
I will attend and willfully participate in all sessions and activities.
I will read and adhere to what is stated in the Confirmation Handbook.
I will not use my cell phone and/or ear buds during any confirmation activities.
I will be respectful of the leaders and facilitators and show appreciation for their time and effort.
I will show respect to those in my class who are on the journey with me.
I will attend Mass every Sunday and on all holy days of obligation.
I will receive the Sacrament of Reconciliation before my Confirmation.
I will accept more responsibility in my family, parish, and community by putting my talents and gifts at the service of others.
I will commit to daily prayer, praying especially for growth in faith, hope and love.

As I make these promises, I ask God to give me the grace to be open to his plans for my lifeplans he reveals to me in prayer, in my talents and aspirations, and in the encouragement of those who know and love me. I place myself in the loving embrace of the Father, Son and Holy Spirit in asking for the help in fulfilling this commitment.

Name of Candidate*

Signature of Candidate*

Signature Witness (Parent or Legal Guardian)*

YOUTH CONFIRMATION APPLICATION

CONFIRMATION EVENTS PERMISSION FORM

MEDICAL CONSENT FORM