Steubenville On The Bayou-June 14-16, 2019
GROUP LEADER REGISTRATION (for registering your group, not individuals). Deposits for early registrations are due Jan. 1st.
Email address *
Prefix *
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Main Telephone Number (where we can reach YOU) *
Your answer
Cell Phone Number *
Your answer
Preferred method of contact *
Church Parish/Group Name *
Your answer
(Arch) Diocese *
Mailing Address *
Your answer
City *
Your answer
State *
I affirm that I am the Group's Leader, will be attending the conference weekend with the group, that I am an adult aged 21 or older and that my name can be on the participant's liability forms as the Group Leader. *
I understand that as the Group Leader I am the one that will be in communication with the Steubenville On The Bayou staff. *
I understand that all adult chaperones must be at least 21 years of age. *
I understand that I need a minimum of one other adult with me for up to the first 8 kids. I also understand that I will need to make arrangements with another group leader to assist with my youth during Men/Women Sessions if I don't have a chaperone of the opposite gender. *
Spots needed *
The total number of youth and adults (including the Group Leader & Chaperones). Remember: (1) You can only drop up to 5 spots before the Drop deadline of May 15th, without penalties and (2) there is a $20 late fee for those spots added after May 1st. I also understand that the deposits are nonrefundable.
Your answer
Will you be paying by Church check or via credit card through Paypal (if so, there will be Paypal fees added)? *
Is this your first times as Group Leader at Steubenville On The Bayou? *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service