Saint Timothy Confirmation Registration

Confirmation Candidate & LEader Registration

Welcome to the ADventure of a lifetime. God has great things in store for you and your family this year. we are so glad you are here and we are honored to journey with you this year.
I am registering for*
NOTE: You Must BE in HIGH SCHOOL TO BEGIN PREPARATION FOR THE SACRAMENT OF CONFIRMATION IN THE DIOCESE OF ORANGE.
Did you complete your first year of Confirmation at Saint Timothy Catholic Church in Laguna Niguel, CA?*

YESNO
NOTE: In order to compelte this registration form you will need the following:
- Copies or photos of Baptism and First Eucharist certificates to upload (unless they were received at Saint Timothy)
- Your medical insurance card
- Your parent(s)/legal guardian(s) present to sign
- Payment method (if you choose to pay now) for the $200 registration fee (per teen) - Note: This amount includes the $40 late fee.
If you have any issues while filling out or submitting this form, please contact Tanner Jauregui at tjauregui@st-timsrc.org for assistance.
NOTE: In order to complete this registration form you will need the following:
- Your medical insurance card (if insured)
- Your parent(s)/legal guardian(s) present to sign
- Payment method (if you choose to pay now) for the $200 registration fee (per teen) - Note: This includes the $40 late fee.
If you have any issues while filling out or submitting this form, please contact Tanner Jauregui at tjauregui@st-timsrc.org for assistance.
NOTE: In order to complete this registration form you will need the following:
- Your medical insurance card (if insured)
- Your parent(s)/legal guardian(s) present to sign
If you have any issues while filling out or submitting this form, please contact Tanner Jauregui at tjauregui@st-timsrc.org for assistance.
NOTE: In order to complete this registration form you will need the following:
- Your medical insurance card (if insured)
If you have any issues while filling out or submitting this form, please contact Tanner Jauregui at tjauregui@st-timsrc.org for assistance.
Do you have any questions, issues, concerns, or feedback for us as we begin the year?
Besides preparation for the Sacrament of Confirmation, are there any other services or needs you have that we can assist with?
Basic needs, Spiritual support, other ministry opportunities, Etc.
Is there any way we can pray for you and your family right now?
TEEN Information
Teen's Full Name*

First NameMiddle NameLast Name
Teen's Sex*

MaleFemale
Teen's Birthday*

MonthDayYear
Date
Teen's City, State of Birth*
Teen Cell*

Area CodePhone Number
Teen E-mail*
example@example.com
Teen's School in Fall 2024*
Teen's Grade in Fall 2024*
Teen's T-shirt Size (In Adult Unisex T-Shirt)*

SMLXLOther
Teen Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Has this teen attended faith formation at Saint Timothy's before?*

YesNo
Last grade of faith formation attended by teen*
Adult LEader Information
Full Name*

First NameMiddle NameLast Name
Sex*

MaleFemale
Birthday*

MonthDayYear
Date
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone*

Area CodePhone Number
Home/Other Phone

Area CodePhone Number
E-mail address*
example@example.com
T-shirt Size (In Adult Unisex T-Shirt)*

SMLXLOther
Baptism Day (If known)

MonthDayYear
Date
Confirmation Day (If Known)

MonthDayYear
Date
Who was your Confirmation Saint?
Favorite Candy*
Favorite Snack*
Your go-to coffee/tea order*
Favorite Place to Spend Money*
Favorite Hobbies or Pastimes*
SACRAMENTAL INFORMATION

If you received any of your previous Sacraments at Saint Timothy, the requirement to upload copies of certificates will disappear once you enter the Church & Location. Otherwise, You will need to upload copies of the certificates.
Has this teen been Baptized in the Catholic Church?*

YesNo
Date of Baptism:*
MM/DD/YYYY
Church of Baptism*
If here, type exactly: Saint Timothy
Location (City, State) of Church:*
If Here, type EXACTLY: Laguna Niguel, CA
Copy of Baptismal Certificate*

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Has this teen received their first reconciliation (First Confession)?

YesNo
Date of First Reconciliation:
MM/DD/YYYY
Church of First Reconciliation
IF HERE, TYPE EXACTLY: SAINT TIMOTHY
LOCATION (CITY, STATE) OF CHURCH:
IF HERE, TYPE EXACTLY: LAGUNA NIGUEL, CA
Copy of First Reconciliation Certificate

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Has this teen Received their First Eucharist (First Communion)?*

YesNo
Date of First Eucharist:*
MM/DD/YYYY
Church of First Eucharist*
IF HERE, TYPE EXACTLY: SAINT TIMOTHY
LOCATION (CITY, STATE) OF CHURCH:*
IF HERE, TYPE EXACTLY: LAGUNA NIGUEL, CA
Copy of First Eucharist Certificate*

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Family Information
Primary Langauge Spoken at home:*

EnglishSpanishOther
Parent's Marital Status (Select all That Apply)*

Married in Catholic ChurchMarried outside of the Catholic ChurchNot MarriedseparatedWidowed (Father is deceased)Widowed (Mother is deceased)Divorced with shared custodyDivorced, Mother has sole custodyDivorced, Father has sole custody
Due to death of parent, or for legal/safety reasons, I will NOT be submitting contact information for:*

FatherMotherI will be submitting contact information for both Parents/Legal Guardian(s)
*PLEASE NOTE THAT UNLESS ONE PARENT IS DECEASED OR IS NOT TO HAVE CONTACT WITH YOUR CHILD FOR LEGAL/SAFETY REASONS, YOU MUST FILL OUT THE INFORMATION FOR BOTH PARENTS.
Father's Name*

First NameLast Name
Father's Religion*
Father's Email Address*
example@example.com
Father's Marital Status*
Father's Cell Phone*

Area CodePhone Number
Mother's Name*

First NameLast Name
Mother's Religion*
Mother's Email Address*
example@example.com
Mother's Cell Phone*

Area CodePhone Number
Mothers's Marital Status*
Mother's Maiden Name*
Teen Lives With*
If Other:*
WHo does your child live with?
Best Parent/Guardian contact number in case of emergency:*

Area CodePhone Number
Who's phone number is this?*
RElationship & Phone type : e.g. "Father CEll"
Is your family registered at St. Timothy's?*

YesNo
Would You like to register at St. Timothy's?*

YesNo
COMPLETE ONLINE REGISTRATION FORM HERE
Is there anything about your family, family history, marital status, etc. that you would like us to know so we can best serve and support you this year? (or "None")*
PARENT Volunteering

PARENTS ARE EXPECTED TO ASSIST IN AT LEAST ONE OF THE FOLLOWING WAYS, SO PLEASE CHOOSE ONE OR MORE OPTIONS.
I can help in the following area(s):*

Prayer Team (at your own schedule)Support Team (Whatever small clerical, administrative or hospitality needs might arise throughout the year)Scholarship/Donor (we will contact you to determine how you would like to serve in this way)Creative Team (help to support our ministry by lending your professional skills in any of the following areas: (Building, Environment, Audio, Visual Art, Lighting/Projection, Photography, Videography, graphic design, printing, social media, marketing, web design). select this team to pick your option(s) below.Year 1 Confirmation Leader (Training, Fingerprinting & Background check required)Year 2 Confirmation Leader (TRAINING, FINGERPRINTING & BACKGROUND CHECK REQUIRED)Life Teen Leader (Sunday nights - TRAINING, FINGERPRINTING & BACKGROUND CHECK REQUIRED)
FOR CREATIVE TEAM ONLY: Which creative area(s) do you have professional experience in (select all that apply and that you would be willing to help us with):

Building (Carpentry, Welding, Set Design, etc.)Environment (Interior Design, Staging, Decoration, etc.)Audio (Sound design, Music, Audio Recording, Mixing, Editing, etc.)Visual Art (Painting, Drawing, etc.)Lighting/ProjectionPhotographyVideography (Recording, Editing, Making Promotional Videos, etc.)Graphic Design (designing graphics, flyers, logos, etc.)Printing (printing flyers, branding merchandise, t-shirts, banners, etc.)Social Media/Marketing (Sharing or creating content for social media or marketing purposes)Web Design
FOR CREATIVE TEAM ONLY: Give a brief description of your skills and experience regarding the selection(s) you made above:
Medical & Emergency Contact Information
Teen's Full Name*

First NameMiddle NameLast Name
Teen's Date of Birth*

MonthDayYear
Date
Teen's Sex*

MaleFemale
Mother/Guardian*

First NameLast Name
Mother Phone*

Area CodePhone Number
Father/Guardian*

First NameLast Name
Father Phone*

Area CodePhone Number
Full Name*

First NameMiddle NameLast Name
Date of Birth:*

MonthDayYear
Date
Sex*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Do you have health insurance?*

YesNo
Insurance Company*
Participants Policy Number*
Group Number
Family Physician
Physician's Phone Number

Area CodePhone Number
Upload Copy of Health Insurance Card (Please upload photos of both sides, unless one side is blank)*

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My Child Has Permission to take the following: (Check all that apply, Select at least one)*

My teen will be taking a prescription medicationMy teen will be taking a NON-prescription medicationMy teen will not be bringing any medications, but I authorize, if needed, school/parish/diocesan staff to give my teen these non-prescription, over-the-counter, medications:
Authorized Non-prescription Medications (or "None")*
Authorized Prescription Medications (Or "None")*
Medical Conditions or Disabilities (or "None")*
Allergies (or "None") *
Dietary Restrictions (or "none") *
In the event of an emergency, and if the parents/guardians cannot be reached, please contact*

First NameLast Name
In the event of an emergency, please contact*

First NameLast Name
Emergency Contact Phone*

Area CodePhone Number
What is this person's relationship to the Teen?*
What is this person's Relationship to you?*
Permission & Liability/RELEASE FORMs
Who is available/able to sign the forms below?:*

Both ParentsMother/Legal Guardian OnlyFather/Legal Guardian Only
DIOCESE OF ORANGE DIGITAL EVANGELIZATION CONSENT AND LIABILITY RELEASE FORM

Parish program(s) are providing digital programming and content for its participants, through which staff will facilitate program activities through online platforms. The program(s) will use software, tools and applications provided by third-parties that participants, parents/legal guardians, volunteers and/or staff will access via the internet and use for purposes of communication and programming and potential content creation. This Form provides your consent and release for your child to participate in the program(s) and utilize these online applications for distance-based, digital program purposes only. Many social media platforms have an age restriction which will always be adhered to by Diocesan staff or volunteers when facilitating activities with children and youth.

Please be aware that each application collects different information about its users and has its own privacy terms and conditions to which members must adhere and which parish or diocese cannot control or assume responsibility. Please review these carefully before registering your child. Our commitment to keeping the children and youth we serve safe is always our number one priority. To that end, we will actively monitor participant activity. All online activities contemplated hereunder must also comply with the Diocese of Orange Technology Guidelines including the Code of Conduct, Policy Against Sexual Misconduct and the Diocese of Orange IT Policy.

DIGITAL FORMS OF COMMUNICATION, ONLINE CLASSROOMS, ETC.

Any and all digital networking and communication including, but not limited to, email, texting, Facebook, Twitter, other Social networking Sites, etc., with parish youth/school/organization will be ministry related, and NOT personal in nature, restricted to matters concerning classes, youth ministry events, parish events, school events, athletic/event schedules, or registration forms.

ARE THERE MEDIUMS OF COMMUNICATION ONLINE OR DIGITALLY THAT SHOULD NOT BE UTILIZED?
My child will NOT have permission to be contacted through the following sites/apps/programs:
(e.g. Zoom, Youtube, Facebook, Instagram, Texting, E-Mail, etc.)
CONSENT & RELEASE OF LIABILITY

I/We, parent(s)/guardian(s) named above grant permission for my/our child, {teensFull3} to participate fully in any and all digital evangelization efforts. These efforts, events and activities will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from Saint Timothy Catholic Church.

I am aware of the Technology Guidelines for the Diocese of Orange, including the Code of Conduct, Policy Against Sexual Misconduct.

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 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 of the Consent and Release Form – Digital Evangelization Media for Children & Youth from the Diocese of Orange (above).

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 and filling out my full address and city, 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.
GENERAL LIABILITY & PHOTO RELEASE

I/We, parent(s)/guardian(s) named above, grant permission for my/our child {teensFull3} to participate in this parish program and all related events. This activity will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from St. Timothy Catholic Church.

As parent(s)/legal guardian(s), I/we remain legally responsible for any personal actions taken by the above-named minor participant. I/We agree on behalf of myself, my/our child named herein, or our heirs, successors, and assigns, to hold harmless and defend St. Timothy Catholic Church, its officers, directors, employees, and agents, and the Diocese of Orange, its employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with my/our child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith. I/We agree to compensate the parish/school, its officers, directors, and agents, and the Diocese of Orange, its employees, agents, chaperones, or representatives associated with the event for reasonable attorney's fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/school or the Diocese of Orange.

I/We authorize the making of photographs, motion pictures, video tapes, recordings, or other memorializing of said event and my/our child's participation therein, and the publication and duplication or other use thereof. I/We waive any rights to compensation or any right that I/we otherwise might have to limit or control such making or use.

I/We 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.

ILLNESS SCREENING

I/We agree to check our own and our above-named minor participant's temperatures before coming to the parish to ensure they are below 100.4 degrees Fahrenheit, observe for symptoms outlined by public health officials, and stay at home if symptoms are present consistent with virus. When on campus, I/we and our above-named minor participant agree to wash or sanitize hands upon entering campus.
Signature of Mother/Guardian*

Clear
Date*

MonthDayYear
Name of Mother/Guardian who signed above:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature of Father/Guardian*

Clear
Date*

MonthDayYear
Name of Father/Guardian who signed above*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
DIOCESE OF ORANGE DIGITAL EVANGELIZATION CONSENT AND LIABILITY RELEASE FORM

Parish program(s) are providing digital programming and content for its participants, through which staff will facilitate program activities through online platforms. The program(s) will use software, tools and applications provided by third-parties that participants, parents/legal guardians, volunteers and/or staff will access via the internet and use for purposes of communication and programming and potential content creation. This Form provides your consent and release for you to participate in the program(s) and utilize these online applications for distance-based, digital program purposes only. Many social media platforms have an age restriction which will always be adhered to by Diocesan staff or volunteers when facilitating activities with children and youth.

Please be aware that each application collects different information about its users and has its own privacy terms and conditions to which members must adhere and which parish or diocese cannot control or assume responsibility. Please review these carefully before registering yourself. Our commitment to keeping the children and youth we serve safe is always our number one priority. To that end, we will actively monitor participant activity. All online activities contemplated hereunder must also comply with the Diocese of Orange Technology Guidelines including the Code of Conduct, Policy Against Sexual Misconduct and the Diocese of Orange IT Policy.

DIGITAL FORMS OF COMMUNICATION, ONLINE CLASSROOMS, ETC.

Any and all digital networking and communication including, but not limited to, email, texting, Facebook, Twitter, other Social networking Sites, etc., with parish youth/school/organization will be ministry related, and NOT personal in nature, restricted to matters concerning classes, youth ministry events, parish events, school events, athletic/event schedules, or registration forms.
CONSENT & RELEASE OF LIABILITY

I {fullName} consent to participate fully in any and all digital evangelization efforts. These efforts, events and activities will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from Saint Timothy Catholic Church.

I am aware of the Technology Guidelines for the Diocese of Orange, including the Code of Conduct, Policy Against Sexual Misconduct.

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

I acknowledge that to review or receive public communications shared via social media, 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 I will not be able to participate 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 of the Consent and Release Form – Digital Evangelization Media from the Diocese of Orange (above).

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 participation in the program(s) and through my authorization, consent and release herein.

By signing this form and filling out my full address and city, 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.
GENERAL LIABILITY & PHOTO RELEASE

I, {fullName}, consent to participate in this parish program and all related events. This activity will take place under the guidance and direction of school/parish/diocesan employees and/or volunteers from St. Timothy Catholic Church.

I remain legally responsible for any personal actions taken by myself. I agree on behalf of myself, my heirs, successors, and assigns, to hold harmless and defend St. Timothy Catholic Church, its officers, directors, employees, and agents, and the Diocese of Orange, its employees and agents, chaperones, or representatives associated with the event, from any claim arising from or in connection with my participation in this program or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith.

I agree to compensate the parish/school, its officers, directors, and agents, and the Diocese of Orange, its employees, agents, chaperones, or representatives associated with the event for reasonable attorney's fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the parish/school or the Diocese of Orange.

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

I 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.

ILLNESS SCREENING

I/We agree to check our own and our above-named minor participant's temperatures before coming to the parish to ensure they are below 100.4 degrees Fahrenheit, observe for symptoms outlined by public health officials, and stay at home if symptoms are present consistent with virus. When on campus, I/we and our above-named minor participant agree to wash or sanitize hands upon entering campus.
Signature*

Clear
Name*

First NameLast Name
Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
As a youth ministry and/or Confirmation volunteer leader at Saint Timothy Catholic Church in Laguna Niguel, CA, I commit to uphold the values, commitments and expectations outlined above. I will lovingly accept any criticism given by the youth ministry and Confirmation staff and I understand, that should I violate this covenant, I will respectfully allow myself to be removed from ministry in the event it is deemed necessary.
Teen Leader Signature*

Clear
Adult Leader Signature*

Clear
Name*

First NameLast Name
Date*

MonthDayYear
Date
Payment
(ADDITIONAL FEES ARE FOR PROCESSING THROUGH PAYPAL. $40 LATE FEE WILL BE APPLIED AFTER OCTOBER 1ST, 2024)
WHAT FEES WOULD YOU LIKE TO PAY RIGHT NOW? (PLEASE SELECT AT LEAST ONE)*
prevnext( X )
LATE Registration Fee ($200 + PayPal fees): $203.00

Registration - Deposit Only ($40.00 + PayPal fees): $41.00

I will pay later: $ Free
Note: $40 LATE FEE WILL BE APPLIED AFTER OCTOBER 1ST, 2024

I cannot pay and need financial assistance: $ Free

Total $0.00
Should be Empty:

Confirmation Candidate & LEader Registration

TEEN Information

Adult LEader Information

SACRAMENTAL INFORMATION

Family Information

PARENT Volunteering

Medical & Emergency Contact Information

Permission & Liability/RELEASE FORMs

Payment