Children & Youth Registration
Kidz Konnection & Confirmation Programming
Parent's Name
*
First Name
Last Name
Parent's Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / 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:
*
Yes
No
I am interested in VOLUNTEERING for Kidz Konnection
*
Yes
No
I am interested in VOLUNTEERING for Confirmation Classes
*
Yes
No
Back
Next
Child Information
Child's Name
*
First Name
Last Name
Gender
*
Male
Female
Birthdate
*
-
Month
-
Day
Year
Date
Age (by 9/1/2025)
*
Grade (Fall 2025)
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?
*
Yes
No
Back
Submit
Register Another Child
Child Information
Child's Name
First Name
Last Name
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?
Yes
No
Back
Finished
Register Another Child
Child Information
Child's Name
First Name
Last Name
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?
Yes
No
Back
Finished
Register Another Child
Child Information
Child's Name
First Name
Last Name
Gender
Male
Female
Birthdate
-
Month
-
Day
Year
Date
Age (by 9/1/2025)
Grade (Fall 2025)
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Allergies/Concerns relevant to Kidz Konnection/Confirmation:
Has child been baptized?
Yes
No
Finished
Should be Empty: