Steubenville 2020

Registration

 

                                        

Who : 8th-12th Graders | Where : Randolph Riverfront Center Alexandria, LA

When :  JUNE 26 - 28, 2020 | Cost : $300                                                                   

For more info. on Steubenville RESTORE Click Here                               

To request a Scholarship contact Fr. Alfredo Villareal: pastor@stphilipcc.com         

 

 

Registrant
Teen Name
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Parent Name
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Teen Phone Number --
Address
Parent/ Guardian Name
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Parent/Guardian Number --
Emergency Contact
Name
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Phone --
Medications/Disabilities
Please list any allergies, including food allergies, if your teen has any. As well as medications that your teen may need to take.
Liability Waver
I agree on behalf of myself, my heirs, successors, personal representatives and assign to protect, indemnify, save, and hold harmless the Diocese of Corpus Christi, St. Philip the Apostle Catholic Church and their officers, directors, agent,s employees, or representatives associated with the Steubenville from all damages, claims, suits, expenses and payment on account of or resulting from conditions stated on or resulting from any such injury, death, or damage to property, including resulting from the negligence of the Diocese of Corpus Christi, and parish, and or their officers, directors, and employees arising from or in connection with my attending Steubenville from June 26- June 28, 2020.
List (Single Choice)
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Photography Consent
I agree to being photographed on this retreat. It is okay to use photos of me alone and in a group setting for social media, presentations, future marketing, and/or just for fun from June 26-28, 2020. If you check 'I do NOT agree' in the box below, please note that YOU are in charge of making sure you are not being photographed.
List (Multiple Choice)
Payment
Shopping Basket The total cost of $300. Consisting of a Deposit of $100 and two payments of $100. Registration will be available online as well as in the parish office.  
Selection Extended

Steubenville Deposit (Due: 1/31) | $100.00

1st Payment (Due: 3/8) | $100.00

2nd Payment (Due: 5/3) | $100.00

OR Pay in Full | $325.00

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