Confirmation Registration

For more information, or if you have questions, please contact Phil Mohr at the church office at 703-430-6455 or by email at youth@sterlingumc.org

Confirmation Registration Form

Student's Full Name (first, middle, last)

Street Address

City State Zip Code

Phone Number

Email Address

Grade in School

Age

Date of Birth

Has the student been baptized? Yes No

Where

Father's Full Name

Mother's Full Name

Legal Guardian's Full Name

Does the child have any allergies or medical conditions we should know about?

Confirmation Sponsor Requests:

(Please list 3 Sterling UMC adults who are not immediate family members who you would like as a confirmation sponsor. Phil will contact them to check their availability.)