Confirmation Registration

Please fill out this confirmation registration form and click submit.
Student Information

 
 
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Parent/Guardian Information

 
 
 
 
 
 
Emergency Contact (other than parent/guardian listed above)

 
 
 
 
Media Release

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Parental Permission Form

The undersigned parent/legal guardian hereby gives permission to Peace Lutheran Church, for the student listed above to attend and take part in activities and events sponsored by Peace Lutheran Church (including, but not limited to, the weekend retreat, servant nights, and other activities that may be scheduled).  Should my child require immediate or emergency medical care, in my absence, I hereby grant the staff and/or volunteers authority to release my child for medical treatment to such medical personnel as the staff and/or volunteers determines appropriate under the circumstances. 


In consideration for the privilege of allowing my child to participate in IGNITE Confirmation, I agree to release and hold harmless Peace Lutheran Church, its officers and agents, from any liability to or responsibility for bodily injury, damage, or illness to the above-identified child/children while participating in any IGNITE Confirmation activity or event.  The information provided on this form is correct and up-to-date.  I have notified the staff and volunteers of any medical information or conditions.  Furthermore, if medical information or conditions change throughout the year, I will inform staff and volunteers of these changes.

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Description

Please fill out this confirmation registration form and click submit.