St Anastasia Catholic Church

Ft. Pierce, FL

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2022 - 2023 Confirmation

- Registration

Confirmation classes for the 2022-2023 year are scheduled to begin in September.

Please Click Here to download and print the Diocesan Medication Form (If your child does not take any specific medication please put N/A and sign the form). Please mail or drop the form off to the Parish Office.

Confirmation Candidates are required to have a Sponsor.
Sponsor forms must be completed and returned by Friday, October 28th.
Please Click Here to download and print the sponsor form.

Please note: If your child is attending John Carroll High School, Confirmation class preparation is not part of their religious curriculum.

Payments for Confirmation must be submitted to the Parish Office prior to class beginning in September. The cost for Confirmation for the 2022 - 2023 year is $135.

Payments can be mailed to the Parish Office at 407 S. 33rd St., Ft Pierce, FL 34947 or dropped off Monday - Friday from 8am to 4pm.
Credit cards payments can also be processed but will incur a fee.
The maximum number of form submissions has been reached. This form is currently not available.
- Student Information
- Student's Full Name (As it appears on Birth Certificate) REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- School Attending REQUIRED Please fill out this field. Please enter valid data.
- Student's Grade ( 2022-2023 School Year) REQUIRED Please fill out this field. Please enter valid data.
- Student's Height & Weight REQUIRED Please fill out this field. Please enter valid data.
- So that we can best serve your child, please list any known conditions that we should be made aware of (i.e. Learning Disabilities, Allergies, Dietary Restrictions, Medications taken, Physical, Emotional, Behavioral, etc.)
- Church of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Year of Baptism REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. 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.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Church where First Communion was received REQUIRED Please fill out this field. Please enter valid data.
- Year of First Communion REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. 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.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Parent Information
- Father's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Home Address 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.
- Father's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email address: Please enter valid data.
- Mother's Full Name REQUIRED Please fill out this field. Please enter valid data.
- Mother's Maiden Name (If applicable) Please enter valid data.
- Mother's Home Address REQUIRED Please fill out this field. 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.
- Mother's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email address: Please enter valid data.
- If Divorced who has legal custody REQUIRED Father Mother Joint Not Applicable Please fill out this field.
- Emergency Contact Information
- Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Relationship to Parents REQUIRED Please fill out this field. Please enter valid data.
- Activity Release and Medical Treatment Waiver
- By selecting I agree below we, the parent(s) or legal guardian(s) do hereby give our permission for our child to attend Confirmation Preparation classes and to be treated for a medical emergency in our absence while participating in the progam. The adult supervisor may act as an agent in our absence.
  
  In case of accident, we do not hold the Diocese of Palm Beach, St. Anastasia Catholic Church, its staff, or the adult/teen catechists/chaperones responsible for accident or injury. We understand that all cost incurred will be our (parent or legal guardian) responsibility. We also understand that if our child breaks any of the program rules, the proper authorities will be contacted and we the parent or legal guardian will be notified of all actions taken and/or to immediately pick up our child from the premises.
  I Agree Please select this field.
- Sponsor Information
- I understand that it is my responsiblity to contact my child's sponsor and have him or her complete the Sponsor Form on our website. All sponsor forms must be turned in on or before October 28, 2022
  I Agree Please select this field.
- Payments for Confirmation must be submitted to the Parish Office prior to class beginning in September. The cost for Confirmation for the 2022 - 2023 year is $135.
  
  Payments can be mailed to the Parish Office at 407 S. 33rd St., Ft Pierce, FL 34947 or dropped off Monday - Friday from 8am to 4pm.
  Credit cards payments can also be processed but will incur a fee.
  I Agree Please select this field.
Submit

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