Confirmation Registration

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  Joshua Hollcraft, Youth Ministry Coordinator - joshua.h@strosechurch.org
  
  7th - 9th grade (email Josh directly if in 10-12th grade)
  Fee: $80 ($40 for any additional children)
  Documentation: Birth, Baptism, and First Communion
  
  Preparation for the Sacrament of Confirmation is a 2 year process. Once you submit this online form, registration is not completed until you turn in fee and documentation.
  
  La preparación para el Sacramento de la Confirmación es un proceso de 2 años. Los jóvenes deben estar al menos en el grado 7 para comenzar. Una vez que envíe este formulario en línea, el registro no se completa hasta que entregue la tarifa de la clase ($80) y los certificados requeridos: certificado de nacimiento, bautismo y primera comunión.
  
  Student | Estudiante
  
  Full Name | Nombre completo REQUIRED Please fill out this field. Please enter valid data.
  
  Gender | Género REQUIRED Male | Hombre Female | Mujer Please fill out this field.
  
  Date of Birth | Fecha de Nacimiento REQUIRED Please fill out this field. Please enter a date.
  
  School | Escuela REQUIRED Please fill out this field. Please enter valid data.
  
  Grade | Grado REQUIRED Please fill out this field. Please enter an integer (number).
  
  Home Address | Dirección de casa REQUIRED Please fill out this field. Please enter valid data.
  
  Sacraments | Sacramentos REQUIRED Baptism | Bautismo First Communion | Primera Comunión Please fill out this field.
  
  Address of the Church of Baptism | Dirección de la Iglesia de Bautismo REQUIRED Please fill out this field. Please enter valid data.
  
  Parents | Padres
  
  Home Number | Teléfono de casa REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Name | Nombre de padre Please enter valid data.
  
  Phone Number | Teléfono Maximum 20 characters Please enter a phone number.
  
  Mother's Name | Nombre de madre Please enter valid data.
  
  Phone Number | Teléfono Maximum 20 characters Please enter a phone number.
  
  Emergency Contact | Contacto de emergencia
  
  Name | Nombre REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship with student | Relación con el estudiante REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number | Teléfono REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Are you or your family registered as parishioners of St. Rose? REQUIRED Yes | Si No Please fill out this field.
  
  Health/Medical Treatment and Consent
  
  In the event of an emergency, if I am unable to be contacted, I, the undersigned parent/legal guardian of the child named on this form, hereby give permission to the Diocese of Sacramento, parishes and schools within the Diocese, and their employees, representatives and adult volunteers to arrange for and authorize emergency medical, dental or surgical treatment for my child, as considered necessary by the attending physician. I wish to be advised prior to any further treatment by the hospital or doctor. I understand that the Diocese of Sacramento and St. Rose of Lima Catholic church do not assume responsibility for payment in an emergency situation. I hereby agree to bear all costs incurred as a result of the foregoing.
  
  I Agree Please select this field.
  
  Submit
  
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