Confirmation Registration Form 2024-2025

Please fill out this form and click submit. If you are Registering more than one child or if you have any questions, please contact the Religious Education Office at (818) 845-3521.

All new and returning students must complete the registration form.

Registration Packet For registration to be complete, all these documents must be submitted (no exceptions):
• Confirmation registration form
• Copy of baptismal certificate
• Teaching, Touching, Safety Permission Form
• Photo Release Form
• Guidelines & requirements agreement Form
• Registration fee

Candidate's Name

Home Address

Date of Birth (month/Day/Year)

Gender

Please select one option.

Male Female

Age

School Attending

Registering For:

Please select all that apply.

First Year Second Year

Sacramental History

Sacraments Recieved

Please select all that apply.

Baptism First Communion

Parent Information

Father/Guardian

Father's Name

Father's Phone

Father's Email

This address will receive a confirmation email

Mother/Guardian

Mother's Name

Mother's Phone

Mother's Email

This address will receive a confirmation email

Are you a Registered parishioner?

Please select one option.

Yes No

Medical Information

Emergency Contact (required)

Contact's Name

Relationship to Child

Emergency Contact Phone

Does your child have any special needs or health conditions? Please Specify.

Describe any allergy (including food allergies), chronic illness or other conditions.

Does your child take any medications? If yes, please list below.

Baptism Certificate

Upload (8MB)

Signed Photo Release

Upload (8MB)

Signed Virtus Permission Slip

Upload (8MB)

Signed Agreement of Requirements Form

Upload (8MB)

Payment

1st /2nd year 1 Child ($95) 1st/2nd year 2 children ($165) 1st/2nd year 3+ children ($235) Continued Ed ($50) Continued Ed 2 children ($90) Continued Ed 3+ Children ($120)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit. If you are Registering more than one child or if you have any questions, please contact the Religious Education Office at (818) 845-3521.

Confirmation Registration Form 2024-2025

Description

Please Fix the Following