Confirmation Youth Registration Form ('23-'24)

Please fill out a form for each 7th-9th grade youth participating in our Confirmation program. We will bless our Confirmation youth during 6 pm worship on Sept. 20th. After worship, we will have an orientation with Confirmation youth & a grown-up. Join us for God's Work, Our Hands as we start the year by serving our community on Sept. 13th.

Youth Info

Name

Birthdate

For example, 2/10/1996

Pronouns He/Him/His She/Her/Hers They/Them/Theirs Other

If you chose other, please share your pronouns.

Gender

Female Male Non-Binary

Grade

7th 8th 9th

School

Dakota Meadows MS East HS Kato Public Charter School Loyola Prairie Winds MS St Peter MS/HS West HS Homeschool Other

If you chose other, which school does your child attend?

Contact Info

Address

Additional Address

An additional address can include a physical address (as opposed to a mailing address), or the address of your child's secondary home.

This address will receive a confirmation email

Phone

If you have multiple emails or phone numbers to use for regular communication, include a semicolon between them.

Youth Cell Phone (if applicable)

Youth cell phone numbers will be used to send reminder texts or to reach your child in an emergency. It will only be visible to staff members.

About Your Youth

What most interests your child? (i.e. swimming, baking, reading, science, drawing, space, etc.)

Among adults, who does your child trust or feel comfortable around in our Bethlehem community? (You can give a general description of someone they connect with well if you can’t think of a name.)

Does your child have any food or life-threatening allergies?

Is there any other information that would be helpful for us to know?

Media Release

We may share appropriate photos or videos of your child participating in our program to tell the story of our church on social media. If you have concerns with this, please reach out to Anna Wencl (annawencl@blcmankato.org)

I understand

Payment

We ask families to pay $25 per year for Confirmation to offset additional programming and curriculum costs. You are welcome to $25 or less via credit card (using this form) or check (by mail or in-person). Checks can be mailed to:

Anna Wencl
c/o BLC
720 S 2nd St
Mankato, MN 56001

As always, your family can pay the full cost, a portion, or nothing, depending on what you can give.

Payment Options (Choose from Dropdown)

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Confirmation Youth Registration Form ('23-'24)

Description

Please Fix the Following