8th Grade Confirmation Prep Registration Form – Epiphany of the Lord Catholic Parish

Name of Child Preparing for Confirmation*
First Middle Last
Name of Child's Father as Listed on Baptismal Certificate*
First Middle Last
Maiden Name of Mother Listed on Baptismal Certificate*
First Middle Last
Please do not list mother’s married name. In the last name box, please ensure the maiden name is written.
Child's Birth Date*
Month
Day
Year
Child's Baptismal Date (approximate)*
Where was child baptized?*
If child was not baptized at Epiphany of the Lord or one of the six east side parishes listed, please provide name of church, city, and state where church of baptism is located
Schooling*
Please list/describe any health concerns or learning issues that may require accommodations in regards to learning/preparing for the sacrament or receiving the sacrament. We will work within your child's needs and abilities to prepare him/her.*
Parent 1/Primary Parent*
First Last
Child's Primary Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent 1 Email address*
Parent 1 Phone*
Secondary Parent/Parent 2*
First Last
Address if different from parent 1
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email address if different from parent 1
Parent 2 Phone*
Please ensure that all required fields (marked with a star) are filled out. If you hit submit and were not redirected to a new page, please scroll to the top of the form to see which areas you may have missed.

Please ensure that all required fields (marked with a star) are filled out. If you hit submit and were not redirected to a new page, please scroll to the top of the form to see which areas you may have missed.