Confirmation

Begin Confirmation Registration:

Parish Membership Status*

Candidate IS a registered parishioner of St. Joseph Catholic Church, Rayne.

Candidate IS NOT a registered parishioner of St. Joseph Catholic Church, Rayne.

For Non Parishioners

If you are registering and planning to confirm with St. Joseph parish but are part of another parish we will first need a written letter of approval from the pastor of your current parish stating that you are in good standing and are allowed to confirm in our parish in order to proceed with registration. If you are part of our parish but have never officially registered please take a moment to fill out our census form and return to the rectory so that we can obtain the proper paperwork for sacramental prep. You can obtain the form at http://stjoerayne.org/contact-us/join-the-parish/ Please inform the secretary of the reason for registration and to notify the Director of High School Faith Formation to expedite the process.

Student Information

Student Name*

First Middle Last Suffix

Gender*

Male

Female

Tshirt*

Grade*

School*

Birthday*

Teen Email*

Teen Phone - (Cell Preferred)*

Mailing Address*

Street Address City State ZIP Code

Medical / Special Needs

Any Special Needs or Medical Conditions*

Yes

Describe any allergy, chronic illness, or other condition.*

Taking any Medications*

Yes

Please list medications and usage instructions.*

Sacramental Information

Mother's Name and Maiden Last Name*

First Middle Last

Father's Name*

First Middle Last Suffix

Baptism

Were you Baptized at St. Joseph?*

Yes

Baptism Date*

Church Name*

City*

State*

Baptismal Certificate*

I understand that I need to provide a copy of Student's Baptismal Certificate.

A baptismal certificate must be provided for those wishing to confirm who have not been baptized in St. Joseph Parish.

First Communion

Did you make First Communion at St. Joseph?*

Yes

First Communion Date*

Church Name*

City*

State*

First Communion Certificate*

I understand that I need to provide a copy of Student's First Communion Certificate.

A First Communion certificate must be provided for those wishing to confirm who has not made their First Communion in St. Joseph Parish.

PRIMARY CONTACT - Parent / Guardian Information

Child lives in a...*

1x Parent / Guardian Contact

2x Parent / Guardian Contact

Parent / Guardian Name*

First Last

Relationship to Student*

Example: Mother, Father, Grandmother, etc...

Phone*

Email*

Marital Status*

Religion*

Please describe any special family situations if applicable:

SECONDARY CONTACT - Parent / Guardian Information

Parent / Guardian Name*

First Last

Relationship to Student*

Example: Mother, Father, Grandmother, etc...

Phone*

Marital Status*

Religion*

Emergency Contact

Name*

First Last

Relationship to Student*

Phone*

Alternate Phone

Model Release / Social Media

PERMISSION GRANTED: I hereby grant permission for my child to be photographed and/or videotaped during Confirmation activities and events. I understand that my child may decline to be photographed and/or videotaped at any time. I further grant permission for the resulting photographs and/or videotaped footage to be edited, if necessary, and then published and/or broadcast for the purpose of promoting Confirmation and/or youth programs at St. Joseph Catholic Church. I hereby grant permission for my child to be contacted via phone, SMS, and social media sites such as but not limited to parish websites, Facebook, Twitter, Instagram, Snapchat, Vimeo, and YouTube for the purpose of promoting Confirmation and/or youth programs at St. Joseph Catholic Church and/or to proclaim our faith that Christ is God, the Savior of humanity and of history, the one in whom all things find their fulfillment. I understand that my child may decline to be contacted at any time.

PERMISSION DENIED: I hereby decline to grant permission for my child to be photographed and/or videotaped during Confirmation activities and events. I have instructed my child to decline to be photographed and/or videotaped at all times. I have further instructed my child to notify Confirmation coordinators and/or Core Team / Volunteer Members that he/she may not be photographed and or videotaped under any circumstances. I hereby decline to grant permission for my child to be contacted via phone, SMS, and social media sites such as but not limited to parish websites, Facebook, Twitter, Instagram, Snapchat, Vimeo, and YouTube for the purpose of promoting Confirmation and/or youth programs at St. Joseph Catholic Church and/or to proclaim our faith that Christ is God, the Savior of humanity and of history, the one in whom all things find their fulfillment. I have instructed my child to decline to be contacted at all times. I have further instructed my child to notify Confirmation coordinators and/or Core Team / Volunteer Members that he/she may not be contacted under any circumstances.

Liability Waiver for Confirmation Classes and Confirmation Retreat: I hereby consent to participation by the Student listed above, in the program listed above, under the guidance and supervision of the parish representative leading the program. I understand that the event will take place at Leader's Homes and at the Retreat Center and that my child will be under the supervision of the designated volunteer teachers. I, the undersigned do hereby release forever, discharge, and agree to hold the Diocese of Lafayette, St. Joseph’s Church in Rayne, Class Leaders, Vehicle Driver(s), Retreat Center, or any Hospital or Medical Center harmless from and against any and all liability, claims, demands, lawsuits and expenses arising from personal injury, sickness, death or property damage of any nature whatsoever which may be incurred or suffered by the undersigned and/or the participant while attending activities. Furthermore, the undersigned assumes all risk of personal injury, sickness, death, damage and expense arising from the undersigned’s or participant’s participation in all activities, including recreation and work activities involved in the above activity. We also allow St. Joseph Parish to provide any and all necessary transportation during the program. We also allow the sponsors to use any photographs taken of the participant during the event in all forms, media and manners, without restriction as to changes or alterations, for advertising, trade, promotion, exhibition or any other lawful purposes. Furthermore, the undersigned agree to indemnify and hold the Diocese of Lafayette, St. Joseph Parish, Leaders, Vehicle Driver(s), Retreat Center, or any Hospital or Medical Center and their respective members, directors, employees and agents (collectively, the “Indemnities”), harmless from and against all claims, demands, actions, lawsuits and liabilities, including attorney’s fees and expenses, sustained by the indemnities as the result of the negligent, willful, or intentional acts of the undersigned and/or participant. If the participant is under 18 years of age: We (I), the parent(s) or legal guardian(s) of the participant, hereby grant permission for our son/daughter to participate fully in the program for which registration is being submitted and all of its undertakings, and hereby give our permission to take said participant to the doctor or hospital and hereby authorize medical treatment, including, but not limited to, emergency surgery, and we, not withstanding any question of liability involved in this emergency, fully and completely, assume all responsibility for all medical bills. Furthermore, should it be necessary for the participant to return home due to medical reasons, disciplinary action, or otherwise, we (I) assume all responsibility and transportation costs.*

Signature of Parent/Legal Guardian - (Use your mouse or finger on a touch-screen device to sign in the white box below.)

Registration Fees

Confirmation Registration Fee*

Confirmation Registration - $100.00

This fee covers expenses incurred by the Confirmation preparation program, including the Confirmation Retreat.

Total

Billing Information

Billing Address*

Street Address Address Line 2 City State ZIP Code

Billing Email*

Billing Phone*

Credit Card

Total

Submit Registration

You will be directed to a confirmation page with further information. Please DO NOT press register button more than once. Doing so may result in multiple billing.

Confirmation Registration 2024-2025

Begin Confirmation Registration:

For Non Parishioners

Student Information

Medical / Special Needs

Sacramental Information

Baptism

First Communion

PRIMARY CONTACT - Parent / Guardian Information

SECONDARY CONTACT - Parent / Guardian Information

Emergency Contact

Model Release / Social Media

Registration Fees

Billing Information

Submit Registration

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