Welcome to the Steubenville Registration/Liability Waiver Form Generator



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Group Information

Please check that the below information is correct and click ‘Next’.


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* Select who you are and click ‘Next’


Your Personal Information




Parent/Guardian Info


Mother or Female Guardian

Please make sure the information below is accurate.


Father or Male Guardian Info


Emergency Contact Info


Same as Guardian?


Health Information (please have your insurance card with you at all times)


Other Information


If I go to college, I will be considering a major in
High school year of graduation
I understand that I need to have an Adult Chaperon Application/Verification Form signed by my diocesan official in addition to this liability form in order to attend the Youth Conference.

Note: If you do not have an Adult Chaperon Application/Verification Form, please contact your group leader or youthconferences@franciscan.edu.


** Please review the Liability Waiver below and sign in the provided box if you agree to these terms.**

** Please review the Liability Waiver below and sign in the provided box if you agree to these terms.**


**Parent Signature Required.**

Instructions:

  • This form is required for attendance and must be filled out and signed by every member of your group. Participants who have not filled out a Liability Form will not be permitted to attend the Conference.

Waiver:

  • I,the undersigned, do hereby release, forever discharge, and agree to hold Franciscan University of Steubenville, and the site organization(s), harmless from any and all liability, claims, demands, lawsuits, and expenses arising from personal injury, sickness, death, or property damage of any nature whatsoever, which may be incurred or suffered by the undersigned participant while attending the above activity.

  • Furthermore, I hererby assume all risk of personal injury, sickness, death, damage and expenses arising from the undersigned participant’s participation in all activities, including recreation and work activities involved in the above activity. In addition, I authorize and grant permission to furnish all necessary transportation, food, lodging, and medical treatment for the undersigned participant. I give permission for diagnoses, treatment, and prescription of medication in accordance with standard medical practice by appropriate health care personnel. I release Franciscan University of Steubenville and the site organization of all responsibility and consequences that may arise as a result of any injury suffered and resulting treatment. Further, I agree to accept any and all financial responsibility as a result of scheduling, acquiring and/or providing medical treatment.

  • By signing this form, I acknowledge that my Group Leader has informed me of the possible sleeping arrangements and conditions, and also of the list of recommended things I should bring along to make my stay more comfortable.

  • I further hereby agree to indemnify and hold Franciscan University of Steubenville, and the site organization(s), and their respective members, directors, employees, volunteers, and agents (collectively, the “Indemnitees”), harmless from and against any and all claims, demands, actions, lawsuits, damages and liabilities, including attorney’s fees and expenses sustained by the Indemnitees as the result of the negligent, willful, or intentional acts of the undersigned and/or participant.

  • Furthermore, I understand that Franciscan University of Steubenville, and the site organization will not be liable if the undersigned participant fails to cooperate with the rules and that any infraction of the rules may result in immediate dismissal from the conference at my expense.

  • I hereby grant to Franciscan University of Steubenville my consent without reservation to use, assign, convey, reproduce, copyright, publish, or sell my/my child’s name, voice, image, and/or likeness that arises from my participation in The Event, whether still or motion pictures, audio or video tape, for promotional, instructional, business or any other lawful purposes, at Franciscan University’s sole discretion.
    I agree to abide by all the rules and regulations stated by Franciscan University of Steubenville, the site organization, and the conference staff.

  • In signing this Agreement, I hereby acknowledge and represent that I have read this entire document, that I understand its terms and provisions, that I understand it affects my legal rights and that it is a binding A greement, and that I have signed it knowingly and voluntarily.


To sign,left-click anywhere in the box above and hold down while using your mouse or trackpad to draw your signature.Click the 'Clear Signature' button to start over.