Confirmation Registration 2025

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Middle Name REQUIRED Please fill out this field. Please enter valid data.

Date of Baptism REQUIRED Please fill out this field. Please enter valid data.

Place of Baptism (Church Name) REQUIRED Please fill out this field. Please enter valid data.

Baptismal Church Mailing 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.

Student Grade in Fall REQUIRED Please fill out this field.

School Attending in Fall REQUIRED Please fill out this field.

Faith Formation Prior to Sacrament (last school year) REQUIRED Holy Family: Mazzuchelli/Wahlert Parish Program: RE or YFF None Please fill out this field.

MEDIA RELEASE AND AUTHORIZATION REQUIRED

I understand that by responding "Yes" I hereby grant authority to my child’s parish for the use of any videos, photos, or similar items to used in social media or on a parish web page.

YES NO Please fill out this field.

PARTICIPANT INFORMATION RELEASE REQUIRED

I understand that by responding "Yes" I hereby grant authority to my child’s parish for the publication of participant information in the parish directory and other parish publications.

YES NO Please fill out this field.

Church of the Resurrection

4300 Asbury Road, Dubuque, IA 52002
(563) 556-7511

Confirmation Registration 2025