Steubenville Live Registration
My signature below indicates that I give permission for those listed to attend the Steubenville Live Virtual Conference. Knowing that there will be proper supervision, in case of injury, I will not hold Corpus Christi Parish, St. Rose of Lima Youth Ministry, or the Archdiocese of Philadelphia or any person or persons connected with them liable. I give permission that, in my absence, my children whose names appear on this form may receive emergency medical care for injuries and situations that should occur while participating in Steubenville Live.
Name *
Email Address *
Phone Number *
Grade entering September 2021 *
Will you be joining St. Rose of Lima at Corpus Christi's view party, or would you rather pray at home? *
I understand that, as long as parish and government regulations allow, conference attendees will meet at a common space at Corpus Christi Parish during the hours of this event. I understand that there will not be an overnight component to this event, and attendees must abide to any and all guidelines put forth by the parish staff, including wearing of masks, honoring social distance requirements, and maintaining necessary hand hygiene. *
In the event that restrictions do not allow a gathering to take place on parish property, I understand that conference activity can be accessed virtually from home and that an inability to gather will not result in a refund. *
Emergency Contact Name *
Emergency Contact Number *
Emergency Contact Email *
Parent/Guardian Signature (If under 18) *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy