Confirmation Form

Confirmation & Youth Group typically alternate on Sundays 4:00pm-5:15pm outside on the grass area behind the church. Please bring chairs, blankets, wear face masks and social distance 10 feet one another.

Class Schedule - 2021-2022 Youth Calendar

 

Tuition - $130* per student

 

Youth Information
Full Name
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Preferred/Nickname:
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Gender
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Date of Birth //
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School
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Grade this Fall
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Youth E-mail
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Youth Cell Phone --
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Home Address
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Youth Lives with
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Other: please specify
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Candidate has received the following Sacraments:
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Family Information
Mother's Name
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Mother's Religion
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Mother's cell phone --
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Mother's Email
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Send regular updates to this email
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Father's Name
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Father Religion
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Father's cell phone --
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Father's E-mail
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Send regular updates to this email
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Service Opportunities at Sun 5:30pm Youth Mass:
I would be interested in learning more about helping with (check all that apply)
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Confirmation Candidate and Parent Agreement
Name of Candidate
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Name of Parent
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I have read, understood, and agree to all the requirements for receiving the Sacrament of Confirmation that are outlined below. I also understand that it is my responsibility to remember and ensure that I complete all of the requirements prior to receiving the Sacrament of Confirmation, which include:
* Weekly worship at Sunday Mass * Satisfactory attendance at Confirmation sessions and Youth Nights and completion of any assignments. * Participation in the Confirmation Retreat on April 30 - May 2nd, 2021 at www.whisperingwinds.org. * Completion of 15 service hours (anywhere) and 5 spirit hours (prayer, adoration, daily reflection) per year. This is done on an honor system. * Personal faith and desire to receive the Sacrament of Confirmation. * Successful completion of 10 min. Confirmation interview with Pastor and Confirmation letter.
I also agree to the following expectations while participating in Confirmation and Youth Group:
* Appropriate behavior and respect towards leaders and peers at all youth nights, events and Confirmation sessions. * Anything dangerous or illegal is prohibited at any youth group and Confirmation event. * Use of kinds speech, and no swearing/profanities. * Arrive on time. * No cell phone or electronic use during Confirmation prep, Youth group is ok. * Dress appropriately: All undergarments must be covered, no exposed midriffs, low-cut, spaghetti strap, strapless, or backless tops. No sagging, inappropriate images or text on shirts, no hats, skin-tight pants, short shorts or short skirts.
I understand that I need to complete all the requirements for Confirmation before I am eligible to receive the Sacrament of Confirmation.
By checking these boxes we are acknowledging you have read and agree to all the above
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Date of acknowledgement //
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Liability Release
Liability Release As parent and/or legal guardian, I remain legally responsible for any personal actions taken by child listed below . I the undersigned agree on behalf of myself, my child’s other parent, listed below, if known or living, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend Ascension Catholic Church, it officers, directors and agents, and the Diocese of San Diego, chaperones, or representatives associated with the event with respect to any and all actions, claims or demands that may be made or brought against the parish, its officers, directors and agents, and the Diocese of San Diego, chaperons, or representatives associated with the event, arising from or in connection with my child’s attending the event or in connection with any illness or injury or cost of medical treatment in connection therewith, and I agree to compensate the parish, its officers, directors and agents, and the Diocese of San Diego, chaperons, or representative associated with the event for reasonable attorney’s fees and expenses arising in connection therewith.
Child Name
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Other parent - Name
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Parent Name
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Parent Signature
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Date //
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Photo/Video Release
I the undersigned authorize Ascension Catholic Church, its representatives, or volunteers, to photograph or record video of the child named below for marketing purposes. Photos, audio or video may be used in print materials and any other visual display or media. I understand that such photo/s and/or video recordings will be used for Ascension purposes and will not be used for any commercial purposes whatsoever. I therefore hereby waive any kind and all rights I may have for remuneration of any kind that could otherwise accrue for the uses of such photos and/or video or audio recordings.
Name of Child
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Name of Parent
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Parent Signature
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Date //
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Medical Matters
I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for his/her health.
EMERGENCY MEDICAL TREATMENT: In the event of an emergency, I hereby grant permission to transport my child to a hospital for emergency medical surgical treatment. I wish to be advised prior to any further treatment administrated by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the number above, please contact.
Emergency Contact Name
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Relationship to child
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Emergency Contact Phone number --
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Family Doctor
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Doctor's Phone --
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Family Health Plan Carrier
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Policy Number
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Special Needs/Medication
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Please list child's name & needs. Send procedure plan to parish office if needed.
MEDICATIONS: CHOOSE ONE OF THE BELOW LISTINGS: (A OR B)
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A) No medication/s of any type whether prescription or non-prescription may be administered to my child unless the situation is life-threatening and emergency treatment is required. B) I hereby grant permission for no prescription medication (such as aspirin, throat lozenges, cough syrup) to be given to my child, if deemed advisable.
Parent Signature
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Date //
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Specific Medical Information
The Parish will take reasonable care to see that the following information will be held in confidence.
Allergic reactions (medication, foods, plants, insects etc
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Please note N/A if not applicable
Immunizations: Date of last tetanus/diphtheria immunization:
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Please note N/A if not applicable
Does child have medically prescribed diet? Provide details if applicable
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Does child have any physical limitations? Provide details if applicable
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Has child recently been exposed to contagious disease or condition?
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such as: mumps, measles, chickenpox, H1N1, COVID-19, etc? If so, date and disease or condition.
You should be aware of these special conditions of my child.
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Other Information
Does child have any learning disabilities?
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Does child have any behavioral issues we should be aware of?
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Confirmation Fees
Tuition is $130.00 per student.
Confirmation Fees  
Quantity Extended

1 Student | $130.00

2 students | $260.00

3 Students | $390.00

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Once form is submitted payment needs to be made to complete registration. There are 2 options for payment. 1) Write a check to Ascension Catholic Church for the amount due. Please note confirmation fees in the memo on the check 2) Make an online payment for the total fees due via the Ascension website. www.sdascension.org, via the donate tab. Please make sure amount is entered in the Confirmation Program Payment field. Please email copy of payment receipt to john@ascension-sd.org.
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Parent Signature
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