Confirmation Registration Form

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Confirmation Instruction Registration Form

Please fill out the form completely to register your child for the upcoming Level One Class

Required *

Child's First Name *

Child's Last Name *

Parent's First Name *

Parent's Last Name *

Father / Mother *

Child's Birthdate *

Street Address *

City *

State *

Zip code *

Phone Number *

Cell Phone Number

Email Address *

Baptismal Date *

Baptismal Officiate (Pastor) *

Baptism Location (Church) *