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.
Emergency Phone Contact*
Please enter a valid phone number.
Email*
example@example.com
We are members of Shepherd of the Hills:*

YesNo
I am interested in VOLUNTEERING for Kidz Konnection*

YesNo
I am interested in VOLUNTEERING for Confirmation Classes*

YesNo

Child Information
Child's Name*

First NameLast Name
Gender*

MaleFemale
Birthdate*

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

YesNo

Child Information
Child's Name

First NameLast Name
Gender

MaleFemale
Birthdate

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

YesNo

Child Information
Child's Name

First NameLast Name
Gender

MaleFemale
Birthdate

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

YesNo

Child Information
Child's Name

First NameLast Name
Gender

MaleFemale
Birthdate

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

YesNo
Should be Empty: