Steubenville Atlanta Youth Conference

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July 11-14, 2019

Participant Commitment Form

This trip is open to rising 9th graders through graduating seniors. We will apply funds from our annual fundraiser on May 18-19 before announcing our final cost, which is expected to be around $275. Financial assistance is available as needed.

NOTE: By submitting this form, you are committing to attending the Steubenville ATL 2019 trip. If you are unable to attend, you are expected to either find a replacement of the same gender or to cover the cost of the trip.

Attendee's Full Name: *

Name for Name Tag:

Attendee Email: *

Attendee Cell Number: *

Permission to contact student: *

My student may be contacted by email and group text with event related information.

Please contact me instead of my student.

Required

Parent email: *

Parent phone number: *

I give my permission and commitment for my student to attend the Steubenville Atlanta Youth Conference from July 11-14 (Sign and date) *

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