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  • Steubenville of the Rockies Registration Form

  • Teen Information

  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Grade in Fall 2023 REQUIRED (Select One) 9th 10th 11th 12th Please fill out this field.
  • Do you have any dietary restrictions? REQUIRED Please fill out this field. Please enter valid data.

  • Parent Information

  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

  • Payment Information

  • Steubenville of the Rockies Conference Fees REQUIRED

    50.0 –  Non-Refundable Deposit

    200.0 –  Cost of Retreat Please fill out this field.

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