Saint Timothy Confirmation Registration

Confirmation Candidate 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.
NOTE: In order to complete 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 (if insured)
- Your parent(s)/legal guardian(s) present to sign
- Payment method for the $175 registration fee (per teen)
Note: This is for Early Bird Registration. Prices increase July 1st.

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
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") *
Teen Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Teen Cell*
ex. (123) 456-7890
Teen E-mail*
example@example.com
Teen's Birthday*

MonthDayYear
Date
MaleFemale
Teen's Grade in Fall 2026*
Teen's School in Fall 2026*
SMLXLOther
Family Information
EnglishSpanishOther
Teen Lives With*
If Other:
WHo does your child live with?
*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 name, Last name
Father's Religion*
Father's Email Address*
example@example.com
Father's Marital Status*
Father's Cell Phone*
ex. (123) 456-7890
Mother's name*
First name, Last name
Mother's Maiden Name*
Mother's Religion*
Mother's Email Address*
example@example.com
Mother's Cell Phone*
ex. (123) 456-7890
Mothers's Marital Status*
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
FatherMotherI will be submitting contact information for both Parents/Legal Guardian(s)
PARENT Volunteering

PARENTS ARE EXPECTED TO ASSIST IN AT LEAST ONE OF THE FOLLOWING WAYS, SO PLEASE CHOOSE ONE OR MORE OPTIONS.
Prayer Team (Will spend an hour in the chapel before the confirmation retreat)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)LIFE NIGHT MEAL (Sunday Nights - Please provide One ENtree for 20 people - 2 times during year)
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
Best Parent/Guardian contact Name in case of emergency:*
First name, last name
Best Parent/Guardian contact Phone number:*
ex. (123) 456-7890
In the event of an emergency, and if the parents/guardians cannot be reached, please contact*
First name, Last name
Emergency Contact Phone (non-parent)*
ex. (123) 456-7890
What is this person's relationship to the Teen?*
What is this person's Relationship to you?*
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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Cancelof
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.
Teen's City, State of Birth*
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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Cancelof
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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Cancelof
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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Cancelof
YesNo
Last grade of faith formation attended by teen*
Permission & Liability/RELEASE FORMs
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. parish website, 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.
Images of My child will NOT have permission to be Posted on the following sites/apps/programs:
(e.g. Parish Website, Zoom, Youtube, Facebook, Instagram, Texting, E-Mail, etc.)
Signature of Mother/Guardian*
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*
Date*

MonthDayYear
Name of Father/Guardian who signed above*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payment
(ADDITIONAL FEES ARE FOR PROCESSING THROUGH PAYPAL. $40 LATE FEE WILL BE APPLIED AFTER OCTOBER 1ST, 2026)

If you wish to request for financial assistance, a deposit of $40 is required along with the filled out form.

If you are unable to pay this or have any other questions, feel free to contact tjauregui@st-timsrc.org for more details.
WHAT FEES WOULD YOU LIKE TO PAY RIGHT NOW? (PLEASE SELECT AT LEAST ONE)*
prevnext( X )
Registration Fee - Early Bird ($175 + PAYPAL FEES)$179.00

Registration - Financial Assistance Deposit Only ($40.00 + PayPal fees): $42.00

I cannot pay and need financial assistance: $ Free

Total $0.00
Should be Empty:

Confirmation Candidate Registration

TEEN Information

Family Information

PARENT Volunteering

Medical & Emergency Contact Information

SACRAMENTAL INFORMATION

Permission & Liability/RELEASE FORMs

Payment