Diocese of Green Bay Extended Steubenville Registration - Students
Welcome to the registration and liability form for the Diocese of Green Bay's Steubenville Extended Pilgrimage July 17th-23rd to Franciscan University - Steubenville, Ohio! We are so excited to have you join us on this wonderful opportunity.

This form is for STUDENTS ONLY to be completed by their PARENT as this serves as their liability form.
Chaperones, priests, and young adults, please register on the separate chaperone link.

No paper form will be needed. Once you submit this form, your spot is officially reserved and a deposit is required to be given to your parish leader. If you are registering as an individual, then a $100 deposit is due to to the Youth Ministry Office.

First Name of Participant *
Your answer
Last Name of Participant *
Your answer
Male or Female? *
Home Address of Participant *
Street Address
Your answer
City, Zipcode *
City and zip code of residence
Your answer
Email Address of Participant *
Your answer
Parents/Guardians Names *
Your answer
Home Phone Number of Parents *
Your answer
Cell Phone Number of Parents *
Your answer
Email Address of Parents that is checked regularly *
Your answer
Student Participant Date of Birth *
MM
/
DD
/
YYYY
Student age by July 17, 2019 *
Student Shirt Size *
Your Parish *
Your answer
Your School *
Your answer
I am registering as...
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