EmailMe Form - 2023-24 Confirmation Registration

If you have questions, please contact:

Vickie Adams in the church office (636-441-7425).

The cost of materials is $40.00. Once you submit this form, you'll be directed to PayPal, which includes a convenience fee of $2.50. If you'd like to bypass that payment option, you can turn in a check to the church office for $40.00.

Name *

First Middle Last

Birthdate *

MM / DD / YYYY

Year in School *

Address *

Street Address City State / Province / Region Postal / Zip Code

Email *

Second Email (optional)

Name of primary adult attending with Confirmand *

Preferred contact number *

### - ### - ####

Additional contact number (optional)

### - ### - ####

We will attend *

3:30 pm

7:00 pm