• Confirmation Registration Form 2021-22   
  

  
  
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  • Are you a register member of St. John the Beloved REQUIRED (Select One) Yes No Please fill out this field.
  • Is your child in the 8th Grade or older? (2021-22) REQUIRED (Select One) Yes No Please fill out this field.
  • First Name Please enter valid data.

    Last Name Please enter valid data.
  • Address Please enter valid data.
  • City Please enter valid data.

    State None AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

    Zip Please enter a zip code.
  • Birthdate Please enter valid data.
  • Age Please enter valid data.
  • Grade (2021-22 Academic Year) *must be in 8th grade or older to enter preparation Please enter valid data.
  • Current School Please enter valid data.
  • Church of Baptism Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • NOTE: If your child was NOT Baptized at St. John the Beloved, please be sure to get a copy of your child's Baptismal Certificate to  Parish Office ASAP. Thank you.
  • Parent #1 Name Please enter valid data.
  • Parent #1 Email Please enter valid data.
  • Parent #1 Cell Please enter valid data.
  • Parent #2 Name Please enter valid data.
  • Parent #2 Email Please enter valid data.
  • Parent #2 Cell Please enter valid data.
  • MODEL RELEASE STATEMENT
    
    I hereby grant permission for my child/children to be photographed and/or videotaped during ministry activities and events.  I understand that my child/children may decline to be photographed and/or videotaped at any time.  I further grant permission for the resulting photographs and/or videotape footage to be edited, if necessary, and published and/or broadcast for the purposes of promoting ministry and/or youth programs at St. John the Beloved Roman Catholic Church.
  • Permission Granted Yes, I grant permission as stated above. No, my child may not be photographed or videotaped under any circumstances.
  • There are FEES associated with preparing or receiving a Sacrament at St. John the Beloved.

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