Confirmation Registration

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The total fee for Confirmation preparation is $160 per student. Once your registration is submitted you will recieve a confirmation email with instructions on how to pay your registration fee with our online portal. If you so choose you can complete your payment in person at the parish offices.
Are you a registered parishioner at IHM? REQUIRED Yes No Please fill out this field.
- How many students are you registering for Confirmation? REQUIRED
  Add up to 5 students per registration. Please only register students of which you are the parent / legal guardian.
  Please fill out this field.
- Student 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Student Email REQUIRED Please fill out this field. Please enter an email address.
  - Gender / Sex REQUIRED Please fill out this field.
  - School Attending in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
  - My child is a sophomore during 24-25 REQUIRED Yes No Please fill out this field.
  - My child has received the following Sacraments: REQUIRED
    Select all that apply
    Baptism First Reconciliation First Communion Please fill out this field.
  - My child was baptized Catholic: REQUIRED Yes No Please fill out this field.
  - My child was baptized at: REQUIRED At IHM A different parish (A photocopy of the baptismal certificate will be needed!) Please fill out this field.
  - So we can better server your child, please list any special needs we need to be aware of.
    For example, developmental or learning disabilities, autism, ADHD, physical restrictions, diabetes, food and other allergies, etc.
- Student 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Student Email REQUIRED Please fill out this field. Please enter an email address.
  - Gender / Sex REQUIRED Please fill out this field.
  - School Attending in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
  - My child is a sophomore during 24-25 REQUIRED Yes No Please fill out this field.
  - My child has received the following Sacraments: REQUIRED
    Select all that apply
    Baptism First Reconciliation First Communion Please fill out this field.
  - My child was baptized Catholic: REQUIRED Yes No Please fill out this field.
  - My child was baptized at: REQUIRED At IHM A different parish (A photocopy of the baptismal certificate will be needed!) Please fill out this field.
  - So we can better server your child, please list any special needs we need to be aware of.
    For example, developmental or learning disabilities, autism, ADHD, physical restrictions, diabetes, food and other allergies, etc.
- Student 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth REQUIRED Please fill out this field. Please enter a date.
  - Student Email REQUIRED Please fill out this field. Please enter an email address.
  - Gender / Sex REQUIRED Please fill out this field.
  - School Attending in 2024-2025 REQUIRED Please fill out this field. Please enter valid data.
  - My child is a sophomore during 24-25 REQUIRED Yes No Please fill out this field.
  - My child has received the following Sacraments: REQUIRED
    Select all that apply
    Baptism First Reconciliation First Communion Please fill out this field.
  - My child was baptized Catholic: REQUIRED Yes No Please fill out this field.
  - My child was baptized at: REQUIRED At IHM A different parish (A photocopy of the baptismal certificate will be needed!) Please fill out this field.
  - So we can better server your child, please list any special needs we need to be aware of.
    For example, developmental or learning disabilities, autism, ADHD, physical restrictions, diabetes, food and other allergies, etc.
- How many parent contacts would you like to register? (up to 2) REQUIRED
  Add up to 2 parents or guardians for your student(s)
  Please fill out this field.
- Parent 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Phone Number 2 Maximum 20 characters Please enter a phone number.
  - Parent Email REQUIRED Please fill out this field. Please enter an email address.
  - Mailing Address Line 1 REQUIRED Please fill out this field. Please enter valid data.
  - Mailing Address Line 2 Please enter valid data.
  - City REQUIRED Please fill out this field. Please enter valid data.
    
    State REQUIRED Please fill out this field.
    
    Zip REQUIRED Please fill out this field. Please enter a zip code.
- Parent 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Primary Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Phone Number 2 Maximum 20 characters Please enter a phone number.
  - Parent Email REQUIRED Please fill out this field. Please enter an email address.
  - Mailing Address Line 1 REQUIRED Please fill out this field. Please enter valid data.
  - Mailing Address Line 2 Please enter valid data.
  - City REQUIRED Please fill out this field. Please enter valid data.
    
    State REQUIRED Please fill out this field.
    
    Zip REQUIRED Please fill out this field. Please enter a zip code.
Payment Agreement REQUIRED
By enrolling my child/children in Immaculate Heart of Mary Parish programs, I accept the commitment of paying program fees. I will fulfill this financial obligation immediately either via the online payment portal or in person at the parish offices.
I agree Please fill out this field.
Media Release REQUIRED
I have read the disclosure, authorization and consent, have had the opportunity to consider their terms and understand them. I grant permission to Immaculate Heart of Mary to use pictures/images of child(ren)in bulletin website and marketing materials.
I Agree Please fill out this field.
Authorization, Consent and Release for use of visual likeness and original works of minors
Social Media and Electronic Communications Authorization REQUIRED
I have read the disclosure, authorization and consent, have had the opportunity to consider their terms and understand them. I grant permission to Immaculate Heart of Mary staff or other leaders to communicate with my child(ren) electronically.
I Agree Please fill out this field.
Disclosure, Authorization and Consent for Social Media or other Electronic Communication involving minors.

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