Registration Form (Kidz Konnection & Confirmation)

Children & Youth Registration

Kidz Konnection & Confirmation Programming
Parent's Name

First NameLast Name
Parent's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Phone Contact
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
We are members of Shepherd of the Hills:
I am interested in VOLUNTEERING for Kidz Konnection
I am interested in VOLUNTEERING for Confirmation Classes

Child Information
Child's Name

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?

Child Information
Child's Name

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?

Child Information
Child's Name

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?

Child Information
Child's Name

First NameLast Name
Gender
Birthdate

MonthDayYear
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?
Should be Empty: