Confirmation Registration 2025-2027

HS Confirmation Registration 2025-2027

Purpose by Life Teen | Holy Trinity Catholic Church, Ladera Ranch
Welcome, we are very excited for you to join the Confirmation Prep Process at Holy Trinity!

Please have the Baptism & First Communion Certificate of the teen ready to upload. If you do not have the certificates, please contact the parishes at which your child received those sacraments. *please have the scanned certificates and card payment for $500 at hand to complete this form.

Student Participant Information
Name*

First NameMiddle NameLast Name
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Date
Age*
What school does your teen attend?*
If your school is not listed please enter it here
Grade*
Student Email
*by entering the student's email, you are authorizing the Office of Youth Ministry to contact for Confirmation & Youth Ministry purposes (Capo Valley High Emails do not allow access to outside organizations including Holy Trinity)
Student Cell Number
*by entering the student's cellphone number, you are authorizing the Office of Youth Ministry to contact for Confirmation & Youth Ministry purposes through Remind
Sacrament Information
Has your teen received their Baptism?*

Yes, at Holy TrinityYes, at another Catholic ParishYes, in a different Christian DenominationNo
Name of church your teen was baptized in:*
Church of Baptism Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where and what date did you receive your Profession of Faith, if applicable*
*Church location and date
Upload Baptism Certificate here*

*scanned PDF or clear photo of certificate
Cancelof
Has your teen received their First Communion?*

Yes, at Holy TrinityYes, at another ParishNo
What church did your Teen receive their First Communion?*
Church of First Communion Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload First Communion Certificate here*

*scanned PDF or clear photo of certificate
Cancelof

Parent/Guardian Information
Is your family registered in our Parish?*

YesNo
Does your family participate in Sacrificial Giving at Holy Trinity?*

YesNo
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Name:*

First NameLast Name
Mother's Maiden Name *
Mother's Email*
example@example.com
Mother's Cell Phone Number*
Father's Name:*

First NameLast Name
Father's Email*
example@example.com
Father's Cell Phone*
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Does the teen participant have any allergies, chronic illness, or medical conditions? If yes, please describe. If not please write N/A.*
Is the teen participant prescribed an Epi-Pen or Inhaler? If yes, please explain any instructions. If not please write N/A.*
Health Insurance Information
Insurance Carrier:*
Policy/Group Number:*

Permission, Liability, Media, Medical Waiver

*Please fill out and sign below
I, [the parent (guardian)] of, name of teen* hereby give my permission for my child's participation in 'Confirmation Preparation' from 2025-2027 school year at Holy Trinity Catholic Church. As a condition of my child being allowed to do so, I hereby release and discharge the Diocese of Orange, Holy Trinity Catholic Church, its constituent organizations, including, but not limited to, The Roman Catholic Bishop of Orange, a Corporation Sole, and their officers, employees and volunteers from any and all claims for personal injuries or property damage that s(he) may suffer as a result of his/her participation in the activity described above, whether or not such injuries or damages are caused by the negligence, active or passive, of any of the entities or individuals named or described above.

I agree to direct my child to cooperate and follow directions and instructions of parish, or Diocesan personnel responsible for all activities.

I agree, that in the event of injury as a result in my or my child's participation in the above activity, including transportation to and from these activities, whether or not caused by the negligence, active or passive, of the parish, school, or Diocesan youth activities program or any of its agents, employees or volunteers, recourse for the payment of any resulting hospital, medical, dental treatment or related costs and expenses will first be had against any accident, hospital, medical or dental insurance, or any available benefit plan of mine or my spouse. I am not aware of any medical condition which would render it inappropriate for participation in any activity.

I hereby give permission to the physician, nurse, dentist or licensed care staff selected by the supervisory personnel then present to render medical, dental or other appropriate treatment deemed necessary and appropriate by the physician, nurse, dentist or licensed care staff.

I, hereby, authorize the making of photographs, motion pictures, video tapes, or other recordings memorializing said event and my child’s participation therein, and the publication and duplication or other use thereof. I, hereby, waive any rights to compensation or any right that I otherwise might have to limit or to control such making or use.
Electronic Consent Release Waiver

*Please fill out and sign below
I, [the parent (guardian)] of, Student Name* to participate fully in any and all digital evangelization. These efforts, events and activities will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from Holy Trinity Catholic Church.

I understand that I will have access to everything provided to my child and be made aware of how social media is being used, be told how to access the sites, and be given the opportunity to be copied on all material sent to my child via social networking, including text messages.

I authorize and consent to staff or other leaders of the parish to communicate with my child electronically, including via social media, text, email, phone and video conferencing tools (e.g. Zoom) in accordance with the program(s).

I understand that if any staff or other leaders knowingly communicate privately with my child as a part of his or her duties for or on behalf of above named school/parish, reasonable steps will be taken to send to me the same communication content, though not necessarily via the same technology.

I acknowledge that to review or receive public communications shared via social media with my child, I will need to become a fan or follower of the same social media. I understand that communications or posts may be accessible or viewable by others who are also fans or followers of the same social media.

I understand that without this consent my child will not be able to participate fully in the program(s). If I choose to rescind my authorization and consent provided herein, I agree that I will inform the parish listed above in writing and that my rescission will not take effect until it is acknowledged by the parish.

I understand, however, that it may not be possible to recall any work, photos or videos that have been published as part of the program(s) prior to receipt of my written rescission.

I have read this Consent and Release Form and have had the opportunity to consider its terms and understand them. I verify that I have read and voluntarily agree to the terms and conditions set out in this Consent and Release Form.

I further hereby hold harmless, release and forever discharge the Diocese of Orange and its employees, agents, licensees and legal representatives from, and shall indemnify them against, all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators or any other person(s) acting on my behalf or on behalf of my estate have or may have by reason of my child’s participation in the program(s) and through my authorization, consent and release herein.

By signing this form below, I am stating that I have read this Consent and Release Form, I fully understand it, and I voluntarily agree to be bound by its terms. I represent and certify that I am the parent or legal guardian of the minor.
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
I have carefully read through this online registration form and I have completed it to the best of my ability*

Yes
Parent Name*

First NameLast Name
Parent/Guardian Signature

Clear

Payment Information*

Confirmation Year I and Year II Registration (2025-2027One time payment of $500 includes both Year 1 & Year 2 registration as well as the Year 1 on-site retreat and Year 2 off-site retreat, supplies, snacks, and t-shirts. *Note: No refunds due to retreat center policy.

$500.00 Quantity

Total

$0.00

Credit Card

Should be Empty:

HS Confirmation Registration 2025-2027

Sacrament Information

Health Insurance Information

Permission, Liability, Media, Medical Waiver

Electronic Consent Release Waiver

Credit Card