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Confirmation Registration

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Thank you for taking this first step to register your child for the Saint Anselm Confirmation Program for 2025-2026. We look forward to working alongside you in making this a meaningful and impactful time of faith formation for not only your child, but you whole family as well.
Contact our Director of Youth Ministry, Courtney Rockamann, with any concerns or questions. She can be reached via phone (314)- 878-2120 ext. 180 or email [email protected].

IMPORTANT DATES:
Confirmation Info Night for parents and Candidates on Sunday, August 24th
Sunday Sessions begin on Sunday, September 7th and are twice a month from
9:15-10:45 a.m.
Required Luke 18 retreat weekend - TBD
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- Parent/Guardian(s)
- Mother's First and Last Name (Maiden) REQUIRED Please fill out this field. Please enter valid data.
- Mother's Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Mother's Email REQUIRED Please fill out this field. Please enter valid data.
- Father's First and Last Name REQUIRED Please fill out this field. Please enter valid data.
- Father's Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Father's Email REQUIRED Please fill out this field. Please enter valid data.
- Primary Mailing Address
- Street 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.
- Home Parish REQUIRED
  If not Saint Anselm, a letter granting permission to be enrolled in our program from your registered parish pastor is required.
  Please fill out this field. Please enter valid data.
- Confirmation Candidate
- 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.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters
  Required for Flocknote text updates
  Please fill out this field. Please enter a phone number.
- Sex REQUIRED Please fill out this field.
- Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- School Attending Fall 2025 REQUIRED Please fill out this field. Please enter valid data.
- T-Shirt Size (unisex adult) REQUIRED Please fill out this field.
- Medical or Allergy Information Please enter valid data.
- IEP or Learning Information Please enter valid data.
- Click HERE to pay before submitting your form.
- Liability Waiver, Medical Consent Form and Behavior Agreement
  1. I recognize that there are risks inherent in participation in any activity and agree to hold the Saint Anselm Parish and the Archdiocese of St. Louis, its affiliates and its and their employees, volunteers and agents, harmless from any injury to my child or damage to or loss of personal property of my child not caused by the negligence or misconduct of Saint Anselm Parish, nor Archdiocese of St. Louis, its affiliates and their employees, volunteers and agents.
  2. In case of a medical emergency, I understand that every effort will be made to contact me, but in the event that I cannot be reached, I hereby give permission for my child(ren) to be evaluated, diagnosed and treated in accordance with standard medical practice by licensed medical personnel.
  3. I give permission and release from all liability the Archdiocese of St. Louis and Saint Anselm Parish to use any photographs or video footage taken of my child in print, on their website, on Instagram, Twitter, Facebook, etc. for promotional purposes.
  4. I authorize employees and agents of St. Anselm and the Archdiocese of St. Louis to give my child nonprescription drugs (such as Tylenol, lozenges, etc.) in the event that circumstances reasonably demonstrate that my child is in need of them.
  5. I agree to abide by and/or instruct my child to abide by all rules and regulations as outliend by the aforementioned chaperones or representatives. I agree that if my child(ren) fail(s) to abide in any way by the rules, that child(ren) may be dismissed from the event and sent home immediately at my expense with no right of reimbursement or refund for any amount in connection therewith from Saint Anselm Parish or the Archdiocese of St. Louis or its chaperones or representatives.
  I Agree Please select this field.
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Confirmation Registration

Parent/Guardian(s)

Primary Mailing Address

Confirmation Candidate