Diocese of Sioux City

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

If you have questions please contact Delores Huemiller at 712-233-7561 or deloresh@scdiocese.org.

Registration

Qty

Description

Amount

Total

Registration

$20.00

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Chaperone/Parent

$5.00

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*IT IS REQUIRED A CHAPERONE BE WITH YOUTH AND PAY $5 FEE.

Total: $0.00

Student/Parent Information

Student Name: *

Birthdate *

Current Grade: *

Student Name:

Birthdate:

Current Grade:

Student Name:

Birthdate:

Current Grade:

Student Name:

Birthdate:

Current Grade:

Student Name:

Birthdate:

Current Grade:

Chaperone Name:

Parent/Guardian Name: *

Parent or Guardian Phone number: *

Parent or Guardian Email: *

Parish Name: *

How did you hear about this event?

Parental/Guardian Consent Form

I/We grant permission for my child(ren), named above, to participate in the 2026 Called Youth Conference on Nov 1, 2026, at St Joseph Parish in Granville, Iowa, sponsored by the Diocese of Sioux City. I will provide transportation to and from the event and will remain onsite with my children for the duration of the event. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above named participant(s). I agree on behalf of myself, my child(ren) named above, or our heirs, successors and assigns, to hold harmless, defend, and indemnify the Diocese of Sioux City and St. Joseph Parish, its employees, and agents and chaperones, or representatives associated with the event for reasonable attorney's fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from negligence of the Diocese and/or Parish.

Consent *

Name/Signature *

Parental/Guardian Photo Consent Form

I/We, the parent(s)/guardian(s) of the above names youth, authorize and give full consent, without limitation or reservation, to St. Joseph Parish and the Diocese of Sioux City to publish any photograph of video in which the above name student(s) appears while participating in any program associated with St. Joseph Parish and the Diocese of Sioux City ministry. There will be no compensation for use of any photograph or video at the time of publication or in the future.

I give my consent

Consent *

Name/Signature *

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *