Faith Formation Registration

Step 1 of 5

Number of Children to Register
Child/Youth #1
Child/Youth #1 Name*
First Last
Grade
Date of Birth
MM slash DD slash YYYY
Have they been baptized?*
Where were they baptized?*
Child/Youth Email
Child/Youth Cell
Child/Youth #1 Food or medicine allergies/dietary restrictions/special health problems or concerns
Child/Youth #2
Child/Youth #2 Name
First Last
Grade
Date of Birth
MM slash DD slash YYYY
Have they been baptized?*
Where were they baptized?*
Child/Youth Email
Child/Youth Cell
Child/Youth #2 Food or medicine allergies/dietary restrictions/special health problems or concerns
Child/Youth #3
Child/Youth #3 Name
First Last
Grade
Date of Birth
MM slash DD slash YYYY
Have they been baptized?*
Where were they baptized?*
Child/Youth #3 Email
Child/Youth #3 Cell
Child/Youth #3 Food or medicine allergies/dietary restrictions/special health problems or concerns
Child/Youth #4
Child/Youth #4 Name
First Last
Grade
Date of Birth
MM slash DD slash YYYY
Have they been baptized?*
Where were they baptized?*
Child/Youth #4 Email
Child/Youth #4 Cell
Child/Youth #4 Food or medicine allergies/dietary restrictions/special health problems or concerns
Child/Youth #5
Child/Youth #5 Name
First Last
Grade
Date of Birth
MM slash DD slash YYYY
Have they been baptized?*
Where were they baptized?*
Child/Youth #5 Email
Child/Youth #5 Cell
Child/Youth #5 Food or medicine allergies/dietary restrictions/special health problems or concerns
Opening Doors Ministry
We welcome the gifts of children of all abilities and encourage them to participate. We will provide Special Friends who will give one-on-one assistance and encouragement to children with attention difficulties, fears, or special needs of any kind.
- Yes, please contact me for a confidential discussion regarding the Opening Doors Ministry

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Parent/Guardian #1 Info
Parent/Guardian #1 Name*
First Last
Parent/Guardian #1 Email*
Parent/Guardian #1 Home Phone
Parent/Guardian #1 Cell Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian #2 Info
Parent/Guardian #2 Name
First Last
Parent/Guardian #2 Home Phone
Parent/Guardian #2 Cell Phone
Parent/Guardian #2 Email
Add different address for Parent/Guardian #2?
- Yes
- No
Parent/Guardian #2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Confirmation Hold Harmless Release
This agreement by and between The Society of the First Presbyterian Church of Lake Forest, Illinois (“Church”) and the Parent/Guardian/Participant in all 2019-2020 Confirmation Program meetings, activities and retreats. The Parent/Guardian/Participant agrees to the following:

1. That the Parent/Guardian/Participant will hold harmless and indemnify the Church from and against any and all claims, demands or suits for loss or damage, brought by any person, arising out of or caused by their participation in the event, regardless of negligence or fault on the part of the Church, and regardless of when such claim, demand or suit is brought.

2. That the Parent/Guardian/Participant hereby waives any and all rights of subrogation, indemnification or contribution that may have or hereafter acquire against the Church or any of its officers, directors, trustees, Ministers, employees or members, arising out of any claim, demand or suit as described in Paragraph one of this agreement.

3. This agreement shall be in effect during the dates noted above, and shall terminate at the end of the confirmation year, April 2019.

4. I hereby give my permission to have my son/daughter treated by qualified medical personnel as a result of an accident or medical emergency while involved in the event. In the event of an emergency and after reasonable, unsuccessful attempts to contact me (us) at the above listed phone number(s), I hereby give permission to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery (under recommendation of qualified medical personnel) for my child/ward to any of the event advisors. I also agree that my insurance will be used for such medical care and I am aware that I will be billed for any medical care not covered by my insurance.
A parent or legal guardian must sign this agreement on behalf of any minor participant under the age of 18. By typing my name as an electronic signature to this agreement, I agree that my electronic signature is the legally binding equivalent of my handwritten signature on paper. By electronically signing this agreement, I represent that I have complete and absolute authority to bind, contract for and legally act on behalf of the minor(s) listed above. By electronically signing and submitting this agreement, I voluntarily agree that 1) I and the minor are bound by this agreement, 2) certify that I am 18 years of age or older, 3) and certify that I am the parent or legal guardian of the minor.
Parent/Guardian Signature*
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Confirmation Fee
The cost for the confirmation program is $300. This fee helps cover transportation, supplies, lodging, meals, snacks, and program costs for both retreats, all service trips and field trips, and weekly class. Scholarships are also available for those who need help covering all or part of the cost.
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Please indicate how you would like to pay the confirmation fee:*
- Online Credit Card Payment (you will be directed to Paypal after you submit this form)
- Personal Check (checks can be made out to "First Presbyterian Church of Lake Forest" and delivered to the church office)
- I am interested in a scholarship
Confirmation Class Fee
Price:

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Faith Formation Registration

Step 1 of 5

Child/Youth #1

Child/Youth #2

Child/Youth #3

Child/Youth #4

Child/Youth #5

Opening Doors Ministry

Parent/Guardian #1 Info

Parent/Guardian #2 Info

Additional Emergency Contact

Insurance Information (for Confirmation Retreat)

Confirmation Hold Harmless Release

Confirmation Fee

Photo Release