Youth Confirmation Form

Youth Confirmation Form

Youth's Full Name (required)

Street Address

City, State, ZIP

Age

Youth Email

Youth Cell Phone

Favorite Candy

Allergies / Medical Issues

Date of Birth

Place of Birth

Grade in School

School Attending

Town of Baptism

Church of Baptism, Including Denomination

Parents' Names

Parents' Email (required)

Parents' Phone (required)

Comments

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