2024 Steubenville June 28th-30th

We are no longer offering the June 28th-30th Steubenville Conference Trip.

 

If you are interested in attending the Steubenville Youth Conference July 12-14th, please contact your Youth Minister. 

 

For questions, please contact Jean Stroud at jstroud@fiatventures.com or your youth minister

Participant Information

*First Name
*Last Name
*Address
Apartment If Applicable
*City
*State
*Zip Code
*Email
*Home Phone (XXX-XXX-XXXX)
Cell Phone (XXX-XXX-XXXX)
*Gender
*Birthdate (mm/dd/yyyy)
*Shirt Size

Parent Information

First Name
Last Name
Email
Home Phone (XXX-XXX-XXXX)
Cell Phone (XXX-XXX-XXXX)

Health Information

Health Insurance Company
Health Insurance Policy Number
*Known Health Issues
*Allergies and any medication you will be taking during the event

Emergency Contact Information

*First and Last Name
*Relationship
*Home Phone (XXX-XXX-XXXX)
Cell Phone (XXX-XXX-XXXX)

Additional Information

Grade
Parish:

Please list requested roommates. Please note we cannot guarantee roommates, but will do our best to accommodate everyone!

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973.500.3300
P.O Box 4292, Warren, NJ 07059

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