Steubenville Registration Form

Steubenville Registration is closed filling out the bellow form
will add you to the waitlist but will not guarantee your registration.

Things I Need After You Register:

1) The $100 Deposit
2) A recent Photo of your student emailed to [email protected]
3) You to save my number in your cell phone. 605-430-7849

Steubenville Northwest

The Steubenville Trip is "Sold Out" if you would like to be on the waitlist please fill out the bellow form.

July 28-31 2022
Spokane, Washington

Cost $400 per person. $100 deposit required with registration.
(We will try and fundraise the $300 but whatever is not fundraised would need to be paid by the student.)

This is the Registration for our parish there will be another registration that will be sent to you for the Diocese of Spokane.


Participant Information


Parent Information


Medical Information


Parish Code of Conduct:

The undersigned do hereby release, forever discharge and agree to hold the St. Joseph Catholic Church, church staff and adult advisors harmless from and against any and all liability, claims, demands, lawsuits, and expenses arising from personal injury, sickness, death, or property damage of any nature whatsoever which may be incurred or suffered by the undersigned and/or the participant(s) while attending the above activity. Furthermore, the undersigned hereby assume all risk of personal injury, sickness, death, damage and expense arising from the undersigned’s or participant(s)’s participation in all activities, including recreation and work activities involved in the above activity. In addition, authorization and permission is hereby given to furnish all necessary transportation, food, and lodging for the undersigned or participant(s). The undersigned further hereby agree to indemnify and hold St. Joseph Catholic Church, and their respective members, directors, employees, and agents (collectively, the ‘indemnities’), harmless from and against any and all claims, demands, actions, lawsuits and liabilities, including attorney’s fee and expenses sustained by the indemnities as the result of the negligent, willful, or intentional acts of the undersigned and/or participant(s). Without compensation, I hereby grant permission to St. Joseph Catholic Church to use and reproduce photographs/videos taken of me or my child(ren). These photographs/videos may be used for news, editorial, or promotional purposes in publications, electronic reproductions, and/or brochures. I hereby release the photographer/videographer, the journalists, and the publications or media outlets they represent, as well as St. Joseph Catholic Church, from all claims and liability relating to said photographs/videos.
If participant(s) is/are under 18 years of age: We (I) are the parent(s) or legal guardian(s) of the participant(s), and hereby grant permission for the above named participant(s) to participate fully in the above activity and all of its undertakings, and hereby give our permission to take said participant(s) to doctor or hospital and hereby authorize medical treatment, including but not limited to emergency surgery; and, we fully and completely assume responsibility for all medical bills. Furthermore, should it be necessary for the participant(s) to return home due to medical reasons, disciplinary action or otherwise, I (we) assume all responsibility and transportation costs. We (I) are the parent(s) or legal guardian(s) of the participant(s), and hereby grant permission for the above named participant(s) to stay overnight in a room throughout the duration of the event with a chaperone and other participants who are 18 or older. I understand that this chaperone will have undergone a background check prior to assignment as a chaperone.
If participant(s) is/are 18 or older: I hereby give my permission to take me and/or the above named participant(s) to doctor or hospital and hereby authorize medical treatment, including but not limited to emergency surgery; and, I fully and completely assume responsibility for all medical bills. Furthermore, should it be necessary for me and/or the above named participant(s), to return home due to medical reasons, disciplinary action or otherwise, I assume all responsibility and transportation costs.
Code of Conduct: It is expected that youth and adults will follow directions of all St. Joseph Catholic Church and Steubenville Northwest volunteers, respective officers, directors, agents, chaperones or representatives associated therein. Males and females are not allowed in the same sleeping area. The use of drugs, tobacco, alcohol or items that endanger people are prohibited. Language and behavior should exemplify Christian values. Respect the rights and property of others. Theft and vandalism will not be tolerated. Clothing must be modest. Any instances of lack of cooperation or insubordination will not be tolerated and will be subject to possible removal and barring from Steubenville Northwest. Parents will be informed of such infraction(s). The participant will be flown home at the participant’s expense with no reimbursement or refund.


Cost: $400. A deposit of $100 is needed for a reservation. Final Payment, due April 29.

All payments are nonrefundable. Payments should be submitted to parish office. Please make checks payable to St. Joseph Church with Stubenville and Student Name in memo.

All chaperones must have a background check through their parish Safe Environment Coordinator prior to the event.

One adult chaperones is required for every 7 youth.

DEADLINE: JANUARY 28, late registrations will be accepted until the conference sells out, or the conference deadline

Submit to Youth Director:
1. $100 deposit (if this has not already been submitted when you click submit you will be taken to our WeShare to pay online or checks payable to: St. Joseph Catholic Church with Stubenville and Student name in memo).
2. Parish liability form (this form).
3. Liability form(s) from the Diocese of Spokane will be sent to participants to complete and return, at a later date.

For more information contact: Taylor Linn [email protected] 605-642-2306


 
 

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