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Health and Liability for Sophomore Retreat

Congratulations on your decision to travel on an off-campus program with CSB/SJU.  The Center for Global Education, CSB & SJU Campus Ministry Offices, the Institute for Women's Leadership, and all of the academic departments are excited to support you in your adventure.

In order to assure that we have the necessary information in case of an emergency, we ask that you please complete the following medical, health insurance and emergency contact information.  This information will only be shared with the office supporting your program and your program director.

You will also need to sign the Short-Term, Off Campus, Program Waiver and Release Form.  Be sure to read each of the linked documents. 

This form will be sumitted to your program director.

Your Demographic Information









Campus
         









MM/DD/YYYY

Do you have a valid passport?