That High School Thing Registration | Resurrection Lutheran Church

Registration and payment for Confirmation programming

Student Name
First Middle Last
Student Phone
Birthdate
Date Format: MM slash DD slash YYYY
School
Grade
Please enter a number from 9 to 12.
Address
Street Address City State Zip Code
Parent(s) Name
First Last
Address
Street Address City State ZIP / Postal Code
Phone 1
Phone 2
Parent Email (Communication will be sent to parent email and to students via text.
Permissions - I authorize Resurrection to:*
Please share any information you want us to know (medical conditions, restrictions, allergies, learning styles, etc):
Other information about your child that would help us relate to and work with him/her:

use my child's name and/or photograph in church multimedia, which may include print, digital and online.
provide transportation to off-site events by approved, licensed drivers over age 21 with completed and cleared background check.