St Andrew Lutheran Church - St Andrew Lutheran Church

Affirm is our confirmation program for students in 6th to 8th grade.
For more information visit - the Affirm page.

Childs's Name(*)

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Current Grade (*)

6th7th8thother

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Date of Birth (mm/dd/YYYY)(*)

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Is this the year you plan to be confirmed?(*)

YesNo

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Child's Email

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Child's Mobile

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Child enrolling in Affirm has the following ALLERGY/ACTIVITY limitations and/or LEARNING restrictions.

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Parent Name - 1(*)

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Parent Name - 2

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Primary Email(*)

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Primary Phone

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Street Address(*)

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City(*)

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State(*)

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Zip Code(*)

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People authorized to pick-up my child(ren).(*)

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Emergency Contact (during Affirm activities)(*)

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Emergency Contact Phone(*)

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Emergency Authorization
If I, or my emergency contact person are unreachable by phone, I authorize counselors and staff from St. Andrew Lutheran Church to seek emergency medical attention for my child(ren) named above, should the need arise. (*)

I agree.

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Photo Release
I GRANT permission for St. Andrew Lutheran Church to use, and publish photos of my child(ren) on the church website, social media, and/or other publicity. (*)

I agree.

I do not agree.

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Parent/Guardian
By entering your name you are acknowledging that the information in the form is accurate, and you affirm the Emergency Authorization, and Photo Release choice made.(*)

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If you have attended Affirm previously (Or even if you haven't):
What was one thing you enjoyed about Affirm?

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If you could change one aspect of Affirm from the previous year(s) what would it be?

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(*)

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Affirm Registration