Confirmation Registration -

Confirmation Registration

Name *

First

Last

Grade in School *

6th Grade 7th Grade 8th Grade

Address *

City, Zip *

Student Cell Phone *

Student's Email *

On Wednesday, Sept. 13th we will Tye-dye T-shirts. Cost of Shirts is $5.

T-Shirt Size *

Parent's Name *

First

Last

Parent's Cell Phone *

Parent's Email *

Home Phone *

As we plan for this fall, we want you to know how you can help. Please check the following things you would consider: *

Comment *

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