Confirmation Request – Holy Nativity Lutheran Church

Child Information

Child's Name *required

Child's Date of Birth *required

Location of Baptism *required

Date of Baptism *required

Parent/Guardian Information

Parent/Guardian Name *required

Parent/Guardian Phone Number(s)

Home

Cell / Mobile

Parent/Guardian Email *required

Address *required

City *required

State *required

Zip Code *required

Affirmation

It is our desire that our child be instructed in Lutherâ€™s Small Catechism in order to prepare his/her heart and mind to receive, through the power of the Holy Spirit, a better understanding of Christian doctrine; the 10 Commandments, the Creed, the Lordâ€™s Prayer, the Sacrament of Holy Baptism, Confession, and the Sacrament of the Altar (Holy Communion).

Parent/Guardian Signature

[signature* signature]

For validation, please type the code above then send form.