Bethlehem Lutheran Church

Connecting people with God, each other and their mission in the world.

4100 Lyndale Avenue South
Minneapolis, MN 55409
612-312-3400 phone

Confirmation Registration Form

This is an opportunity for Junior High youth to grow in faith, to affirm the faith in which they were baptized, and to become an engaged, adult disciple of Christ.

The following is the 2008-2009 Bethlehem Lutheran Church Junior High Ministry Registration Form for Confirmation. Attached is the pdf of the Confirmation Covenant and Events Brochure. Note that a signed medical release is required. Please print out the PDF and mail this release to the Bethlehem office c/o Gena Koeberl.

Thank you!

DUE: August 28

Name of Confirmation Student: *

Date of Birth: *

Grade in the Fall: *

School in Fall 2008: *

Parents/Guardian:: *

Email: *

Work Phone: *

Home Phone: *

Cell Number:

City/Zip: *

Address: *

Primary E-mail for Confirmation News: *

Parents/Guardian (if different from above):

Parents/Guardian 2 Phone #:

Parents/Guardian 2 E-mail address:

Cell/Work/Phone #:

Address 2:

City/Zip 2:

Insurance company for student: *

Policy #: *

Phone # for Insurance:

Insurance Company Address:

Mentor's Name: *

Mentor's Address: *

Mentor's Home Phone: *

Mentor's E-mail:

Worship: *

Bethlehem Lutheran Church

Spirit Garage

Jacob's Well

Other

Choose where you will be attending

Allergies, Asthma, medical, learning or other conditions: *

Attachment	Size
Confirmation Covenant.pdf	47.3 KB
2008 Conf Brochure.pdf	1.1 MB
MEDICAL REGISTRATION FORM.pdf	15.4 KB

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