Is your teen currently enrolled in the St. Andrew Youth Group? *
Grade Entering *
Graduation Year *
Please list 1 other teen to room with. I will do my best to have them room together but can not promise it will be possible.
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Possible Major
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I'm not planning on attending college
Accounting
Anthropology
Biology
Business
Catechetics
Chemistry
Classics
Communications
Computer Information Science
Computer Science
Drama
Education
Engineering
English
French
German
History
Humanities & Catholic Culture
Mathematics
Music
Nursing
Philosophy
Political Science
Psychology
Social Work
Sociology
Spanish
Theology
Youth Ministry
Undecided
Another Major not on this list
Do you have any dietary restrictions or food allergies? *
Required
Address
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City
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State
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Zip Code
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Home Phone
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Teen's Phone Number (for GroupMe) *
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Teen's Email Address *
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Number of Steubenville Conferences Attended *
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Title of Primary Parent/Guardian
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Mr.
Mrs.
Ms.
Primary Parent/Guardian First Name *
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Primary Parent/Guardian Last Name *
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Relationship of Primary Parent/Guardian to Participant
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Mother
Father
Legal Guardian
Other
Primary Parent/Guardian Home Phone
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Primary Parent/Guardian Cell Phone *
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Primary Parent/Guardian Email Address *
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Title of Secondary Parent/Guardian
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Mr.
Mrs.
Ms.
Secondary Parent/Guardian First Name
Your answer
Secondary Parent/Guardian Last Name
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Relationship of Secondary Parent/Guardian to Participant
Choose
Mother
Father
Legal Guardian
Other
Secondary Parent/Guardian Home Phone
Your answer
Secondary Parent/Guardian Cell Phone
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Secondary Parent/Guardian Email Address
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There is a $60 non-refundable deposit due by March 3 to hold your teen's spot. The link to pay your deposit will appear on the next page after you submit your registration. *