Steubenville 2018

July 20-22, 2018
Steubenville - Missouri State University

Steubenville Mid-America is a high-energy youth conference where approximately 3500 teens come together on the Missouri State University college campus and pack the MSU Arena throughout the weekend for dynamic speakers, engaging music, Sacraments and fun.

In order to register, please note that there are three steps to complete:

STEP 1. Scroll down and complete the Diocese Participation Form below. From there, you will be prompted to Step 2 for the Steubenville Conference Registration and then you will return to that same page for Step 3, the payment.

STEP 2. Complete the Steubenville Conference Registration click here. Note: Upon completing the registration above, you will need to return to this page to complete step three below.

STEP 3. Pay online here for the $100 deposit or full retreat payment. ONLY electronic payments are accepted for Steubenville. If registered and paid in full by April 22, the expense is $280. After that date, the cost increases to $310. Confirmation candidates reduce the cost by $25, in addition to the "work week reductions". Scholarship applications are due April 15.

STEP ONE:
DIOCESAN PARTICIPATION FORM

1. EVENT INFORMATION

St. Andrew's Youth Ministry in conjunction with Steubenville 2018 REQUIRED Friday, July 20 at 7:00am until Sunday, July 22, 2018 at 8:00pm. Bus transportation to/from St. Andrew to MSU Campus, 900 E Monroe St, Springfield, MO 65807. Stopover activities on Friday and Sunday. Please fill out this field.
NOTE: The total value of the conference trip is over $330!

Payment includes:
* All meals from Friday morning until Sunday night
* Friday fun activities T.B.D. (i.e., Escape Room, Main Event Entertainment Center, Sky Zone Trampoline Park, etc.)
* Sunday Incredible Pizza buffet and entertainment attraction card, Springfield MO
* Three T-shirts
* Motor coach transportation
* Overnight a ccommodations in dorm rooms, separated by gender
* Steubenville conference--high-energy youth conference with nationally known speakers, engaging music, and entertainment, plus Mass on Saturday and Sunday, Adoration and more.

2. PARTICIPANT INFORMATION

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Birthdate REQUIRED Please fill out this field. Please enter valid data.
Parent/Guardian Full Name REQUIRED Please fill out this field. Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
Home Telephone REQUIRED Please fill out this field. Please enter valid data.
Parent's Mobile Number REQUIRED Please fill out this field. Please enter valid data.
Parent's Work Number REQUIRED Please fill out this field. Please enter valid data.
Other Contact in Case of Emergency REQUIRED Please fill out this field. Please enter valid data.
Dorm room is 3 per room. Please list preferred roommates. REQUIRED Please fill out this field. Please enter valid data.
Adult T-Shirt Size REQUIRED Please fill out this field.

3. PERMISSION OF PARENT/GUARDIAN

Student Name REQUIRED Please fill out this field. Please enter valid data.
I/We, the parent(s)/guardian(s) of the student listed above, request that he/she be allowed to participate in the Event described above, and hereby give my/our permission for such participation.
I agree to the above statement REQUIRED I agree. I do NOT agree. Please fill out this field.
I/We give my/our permission to the sponsoring Diocese/Parish/School/Organization to take photographs, video or digital images of Participant during any events for future promotional purposes.
I agree to the above statement REQUIRED I agree. I do NOT agree. Please fill out this field.

4. CONSENT FOR DISCLOSURE TO INDIVIDUAL INVOLVED IN THE CARE AND TREATMENT OF PARTICIPANT

For the duration of the Event, I/We grant to the Diocese/Parish/School/Organization and its agents the following powers, to be used for the benefit of and on behalf of Participant:

A. to receive any and all individually identifiable health information about the past, present and future medical condition of Participant, including, but not limited to, information necessary to the care and treatment of Participant and any illness or injury Participant may have sustained;
I agree to the above statement REQUIRED I agree. I do NOT agree. Please fill out this field.
B. to authorize medical care for Participant, including, but not limited to, any and all treatment, examination, diagnosis or outpatient medical care rendered under the general or special supervision of and on the advice of any physician or surgeon licensed to practice medicine by the applicable licensing body in the state in which physician or surgeon practices.
I agree to the above statement REQUIRED I agree. I do NOT agree. Please fill out this field.
C. I/We understand that the Diocese / Parish / School / Organization will not be liable to me/us or any or my/our successors in interest for any action taken or not taken in good faith.

I/We understand that as parent(s) or legal guardian(s), I/we may be responsible for any liability which may result from the conduct of Participant at or during the weekly sessions or events. I/We understand that there is a risk of injury involved in any Youth Ministry activity.

I/We hereby release the Diocese of Kansas City-St. Joseph, and its officers, agents, employees and volunteers, from any liability arising from claims of any kind or nature whatsoever in connection with Participant's participation in the weekly sessions and events.
I agree to the above statement REQUIRED I agree. I do NOT agree. Please fill out this field.

If you do not agree to all of the above statements, please elaborate here. Please enter valid data.

TEXTING

ELECTRONIC SIGNATURE

The above student has permission to attend this event. By typing my signature below, I attest that I am the legal parent /guardian of the student. Type Signature Below REQUIRED Please fill out this field. Please enter valid data.

St. Andrew the Apostle

Catholic Church and School

Steubenville 2018

July 20-22, 2018
Steubenville - Missouri State University

In order to register, please note that there are three steps to complete:

STEP ONE:
DIOCESAN PARTICIPATION FORM

Steubenville 2018

July 20-22, 2018 Steubenville - Missouri State University

In order to register, please note that there are three steps to complete:

STEP ONE: DIOCESAN PARTICIPATION FORM

July 20-22, 2018
Steubenville - Missouri State University

STEP ONE:
DIOCESAN PARTICIPATION FORM