Ezekiel's Confirmation Registration 2026-2027

Please complete the following form for each child you register.

Child's Full Name (first, middle, and last)

Child's Birthday

Is your child baptized?

Yes Unsure No, but I'd like more information.

When was your child baptized? (not required)

What grade is your child in (as of Fall 2026)? 7th Grade 8th Grade 9th Grade

Family Address

Primary Parent/Guardian Email

This address will receive a confirmation email

Primary Parent/Guardian Phone

Do we have permission to text this number?

Yes No

Please indicate your church affiliation.

I am a member of Ezekiel. I am not a member of Ezekiel but would like to learn more. I attend another a church other than Ezekiel. Prefer not to say.

Do we have permission to take and share photos of your child/ren?

Yes No

Please list any allergies. We regularly provide dinner and snacks for students.

Please indicate here if there are any medical needs for which we should be aware of.

Adults, are you interested in supporting Confirmation? Select all the boxes that apply. I am interested in leading a Small Group with guided instruction. I am interested in subbing as needed. I am interested in being a mentor for a 7th grader during Lent.

Parent Agreement: If I am in attendance, I agree to be involved actively in the supervision of all children. If I observe any unsafe or disrespectful behavior, I will take the time necessary to provide the needed guidance and adult supervision. My overall goal is the safety and Christian education of all children. I will keep this ministry in my prayers. I, the parent/guardian of the child(ren) listed above, hereby authorize a representative of Ezekiel Lutheran Church to authorize emergency healthcare for my child(ren) if necessary. I, hereby authorize the staff and/or volunteers of Ezekiel Lutheran Church Confirmation program to take my child on a field trip which is part of this education program. I hereby hold the staff and/or volunteers of Ezekiel Lutheran Church harmless for any injury or harm that my child may incur while participating in these programs, a related field trip, or service project of the said programs. Field Trips are always planned in advance and parents are given notice as to when they are happening. For off-site activities without a parent present, there will be a healthcare form to complete. Typing your name below will act as your signature to this agreement.

Ezekiel's Confirmation Registration 2026-2027

Description

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