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Steubenville West 2026 Registration/Payment/Parent Permission Form

- Steubenville 2026 Registration/Payment/Parent Permission Form
  
  Participant First Name, Middle Name, Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth (Month/Day/Year) REQUIRED Please fill out this field. Please enter a date.
  
  T-shirt Size REQUIRED Small Medium Large XL XXL Please fill out this field.
  
  PAYMENT PORTION
  
  Registration Fee300.0
  
  PARENT PERMISSION FORM
  
  To the Supervisory Personnel of Religious Ed
  St.Thomas the Apostle Parish
  Tucson
  
  I hereby consent to person designated above participating in the experience described below:
  
  Experience: Steubenville West 2026
  Dates & Place: July 17 - 19, 2026
  Tucson Convention Center
  Tucson, Arizona
  Transportation provided by: Parents
  
  I have directed my teen to cooperate and conform to the directions of the supervisory personnel in charge. Should it be necessary for my teen to have medical treatment while participating, I hereby give the supervisory personnel permission to use their judgment in obtaining medical service for my child. I give permission to the physician selected by the supervisory personnel to render medical treatment deemed necessary and appropriate by the physicians.
  
  I agree that in the event my teen is injured as a result of his or her participation in the experience, including transportation provided by the program, through the negligence (active or passive) of the parish or any of its agents or employees, recourse for the payment of any resulting hospital, medical or related costs and expenses will first be had against any accident, hospital or medical insurance, or any available benefit plan of mine or my spouse.
  
  I release the Diocese of Tucson, St Thomas the Apostle Parish, Father Pat Crino, and all diocesan and church staff from all claims, losses, costs, damages, or expenses arising out of or from any accident or other occurrences causing injury to any person or property.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parent Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Date Authorized REQUIRED Please fill out this field. Please enter a date.
  
  Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Specify any/all allergies
  
  Specify dietary needs
  
  Total:
  
  Submit
  
  Proceed to Payment