Youth Confirmation Registration

Date of Registration

Student's Information

Name(Required)

First Last

Gender(Required)

Female

Male

Date of Birth(Required)

Place of Birth(Required)

Grade(Required)

Sacramental History

Baptism Date(Required)

Baptism Parish Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Has the teen received First Holy Communion?(Required)

Yes

First Communion Date

First Communion Parish Name

First Communion Parish Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parents' or Legal Guardian's Information

Mother(Required)

First Last

Mother's Cell Number

Mother's Email(Required)

Father(Required)

First Last

Father's Cell Number(Required)

Father's Email(Required)

Parent's Consent

Contribution(Required)

We require a $80.00 contribution to cover the expenses of the sacramental preparation and Confirmation Certificate.

I agree to the $80.00 Contribution

Image Disclosure Consent

Permission for Image Disclosure of Child.(Required)

Yes, I would like to authorize.

No, I would not like to authorize

Permission for Image Disclosure(Required)

Yes, I DO authorize the Faith Formation department of St. Catherine of Siena Parish, in Kissimmee, FL to take photos, videos or any type of recording of my child to be used in the Parish Bulletin, Parish Website, or any other Parish Form. I waive from any claims, and release all the staff members, volunteers of St. Catherine of Siena Catholic Church in Kissimmee, FL, and/or the Diocese of Orlando, weather former, future, or current, from any and all claims, actions, cause of actions, suits, costs, expenses, liabilities, or/and damages.

Youth Confirmation Registration