Register for 2024 Steubenville Main Campus 3

Participant Information
Participant's Name*

First NameLast Name
Participant's Birthday*

MonthDayYear
Participant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Participant's Home Number*

Area CodePhone Number
Participant's Email
Shirt Size*
Grade Entering in Fall 2024
HS Graduation Year
Allergies/Dietary Needs
Parent/Guardian Information
Primary Parent/Guardian's Name

First NameLast Name
Home Number

Area CodePhone Number
Primary Parent/Guardian's Cell Phone Number

Area CodePhone Number
Primary Parent/Guardian's E-mail
Secondary Parent/Guardian's Name

First NameLast Name
Secondary Parent/Guardian's Cell Phone Number

Area CodePhone Number
Secondary Parent/Guardian's Email
Payment
In order to secure a spot for the participant a $50 deposit must be received in order to secure a spot. You can choose to pay the deposit now and the rest later or you can make a full payment as well.

Deadline for Full Payment: May 29th

Deposits are non-refundable and must be made in order to secure a spot.

Please email brichards@olmmparish.org if you have any concerns about the deposit or full cost of the conference.

If you cancel after May 29th then the full cost will be non-refundable.
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Steubenville Conference Fee

Steubenville Deposit$50.00

Steubenville Full Payment$260.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

By clicking "Submit," I, as the parent/guardian, agree to pay the Full Payment of $260 by May 29th (unless otherwise arranged with OLMM or Saint Theresa's) and agree to the cancellation policies stated above.
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