St. Helen Confirmation 2026-2027

St. Helen Church Newbury OH

Confirmation Registration 2026-2027
Child's Name

First Name (as you want it to appear on certificate) Middle Name Last Name
Date of Birth

MonthDayYear
Date
Place of Birth
City and State
T-shirt size
Child Attends
Church of Baptism-If not baptized at St Helen you must submit a baptismal certificate (If you previously submitted one you do not have to do it again)
Include Church Name, City & State
Date of baptism

MonthDayYear
Date (please make sure this is accurate)
Father's Name

First NameLast Name
Father's Religion
Mother's Name

First NameMAIDEN Name
Mother's Religion
Address

Mailing Address

Street Address Line 2

Citystate

Postal / Zip Code
Primary Email
example@example.com
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does your child have any allergies, medical conditions or learning disabilities?
Please give details (Confidential)
I give permission for my child's picture to be displayed at St Helen Church, School and on-line at our website and through our Church or School social media accounts.
Payment Information

Payment of $50 is due on or before Aug 24th 2026. You can pay by cash or check made out to St Helen or through on-line giving. If you choose on-line giving, after you submit this form you will be directed to the website to complete payment.
I intend to pay by
I, undersigned, agree with the following statements:
Date

MonthDayYear
Date
Signature
Should be Empty:

St. Helen Church Newbury OH