2017 Steubenville High School Youth Conference
Dates: June 23-25.
Cost: $295 for students, $315 for everyone else.

Included here: Registration, Consent and Code of Behavior Acknowledgement Forms, link for payment.

Email address *
Primary correspondence email address *
Please provide us a primary email address which can be used for all future email correspondence as well as your registration ID. This email address can be the same as the one above. It should be the email address of a parent or a guardian.
Your answer
Secondary correspondence email address
You may provide us with a second email address which we will use for all email correspondence. This is not required.
Your answer
Youth Information (all information is required):
Participant First Name *
Your answer
Participant Last Name *
Your answer
Participant Cell Phone # *
Please enter using this format: ########## (don't uses spaces, dashes or brackets)
Your answer
Participant email *
Your answer
Participant tee-shirt size *
We will be providing two tee-shirts, one for Friday and one for Saturday
Parent/Guardian Information (one is required):
Your Cell # *
Please enter using this format: ########## (don't uses spaces, dashes or brackets)
Your answer
Your Home Phone # *
Please enter using this format: ########## (don't uses spaces, dashes or brackets)
Your answer
USE OF PHOTOS *
We hope to capture the joy of the weekend in photographs and videos to be used in the St. Andrew bulletin, website, social media and future promotional publications.
Required
CONSENT AND AGREEMENT
Code of Behavior
We are happy and excited that you are joining us as part of Saint Andrew 2016 Steubenville Youth Conference trip. The Code of Behavior is a way of helping participants understand what is expected of them during the trip, and of making the experience an enriching one for all involved. Please read through the Code carefully, as you will be expected to honor and uphold it throughout your time at the Conference. Team members will travel to all program activities as a group. Participants are expected to attend all sessions unless explicitly excused by the Parish Conference Coordinator. Name badges should be worn at all sessions and meals. Dress at the Conference should be casual but modest. No short shorts, tank tops, belly shirts, t-shirts with suggestive or violent language, spaghetti straps or strapless tops, cut off t-shirts or extra baggy clothing. Participants must be in their respective rooms by curfew time. The noise level in the sleeping areas should be kept at a minimum. Scheduled quiet and silent times must be honored. The purchase, possession or consumption of alcohol, cigarettes or drugs by participants will result in immediate dismissal from the Conference. Major infractions of the Code of Behavior will meet with the same consequences. Any and all safety, security and disciplinary regulations established by Steubenville Youth Conferences also apply.
Parent or Guardian Signature *
By signing below, I agree that my child shall abide by the rules and regulations outlined in the Code of Behavior. I have reviewed it and discussed the Code with my child prior to signing this form. I agree that if my child fails to consistently abide by the Code or engages in a serious infraction of the Code, he or she may be immediately dismissed from the Mission and sent home at my expense. (Please indicate your acceptance here by entering your first and last name.)
Your answer
Youth Participant Signature *
By signing below, : I understand and agree with the terms and conditions of the Code. I also understand that my parent and/or guardian will be notified at the time of any infractions requiring my dismissal from the Mission and that I will be sent home at my own or my parent’s expense. (Please indicate your acceptance here by entering your first and last name.)
Your answer
Date *
Today's Date
MM
/
DD
/
YYYY
LAST STEPS
Once you have completed the above and submit this form, a copy of your responses will be emailed to you for your records. The email will include the link to make your payment online. The cost for students is $295. The cost for everyone else is $315. If you would like you can pay online here now with this link:

https://goo.gl/3N1PWm

If you prefer to pay by check, write a check to "St. Andrew Catholic Church," put the check in an envelope marked "Steubenville, Attention: Kathleen Kajmo" and drop it off at or mail it to the St. Andrew Catholic Education Center, 51 Wrights Road, Newtown PA 18940.

Upon submitting this form, you will have registered with St. Andrew Church for the Steubenbille Conference! But it is also required that you submit your child's information directly to the Steubenville Youth Conference. In the email you get for your own records you will get also get a link to submit your information directly to Steubenville. Here is the link if you would like to fill it out now:

https://liability.steubenville.org/app/daf1ef

Thank you for registering to join us at Steubenville! It promises to be an incredible experience for your teen!

St. Andrew Youth Ministry

A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Saint Andrew Catholic Church. Report Abuse - Terms of Service - Additional Terms