Confirmation Registration

Name
First Middle Last
Address
Street Address City State Zip Code
Phone
Email
Birthdate
Date Format: MM slash DD slash YYYY
Current Grade
Middle School
High School (Fall)
Have you been baptized?
- Yes
- No
Interests/ hobbies
Parent(s)Name(s)
First Last
Parent(s)Name(s)
First Last
Parent's Email
Are your parent(s) members of St. Andrew?
- Yes
- No
Food Allergies
For Retreat Snacks