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Youth Ministry

DYC Liability, Medical and Consent Form

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Participant Information

Please type your full name.

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Event Information

Event: Diocesan Youth Conference (DYC)

Event Date: 1/31/20 – 2/02/20

Event Location: Macon Marriott City Center


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Medical Matters

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Emergency Medical Treatment
In the event of an emergency, I hereby give permission to be transported to a hospital for emergency medical or surgical treatment. In such an event, please contact:

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Medications


Specific Medical Information

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Code of Conduct and Expectations of All Participants

Each chaperone, participant and Young Adult Helper must agree to these rules. Chaperones, please read carefully as you will be asked to enforce these policies.


Everyone

  • Alcohol, illegal drugs and tobacco are prohibited (NO SMOKING)
  • Weapons are prohibited
  • Dress code:
    Shorts and/or skirts must come to at least the knees
    No low-riding pants
  • Must be spiritually mature whose language, conversation and actions reflect the teachings and moral values of the Catholic Church
  • I understand that I will be expected to remain on-site for the entire time of the event.
  • No refunds will be given.

PHOTO RELEASE FOR INTERNET AND NEWSPAPER: I hereby grant permission for photographs taken of me at this event to appear on one of the communication mediums of my parish/school/organization (bulletin, newsletter, website, etc.) and/or the Catholic Diocese of Savannah (e.g., The Southern Cross or diocesan websites)l. I understand that these images will be used only in relation to these publications and this event. Any other use of said images will require my full written consent.


Participants

  • Participants must be within the age range of the event
  • No cell phones, iPods, or electronic devices

Chaperones

  • Chaperones must be 21+ years of age and in compliance with “Diocese of Savannah’s Safe Environment”
  • Be aware of any significant health issues and pre-existing conditions affecting the members of your group. Any illness or health problems developing during the conference should be reported to the health care staff
  • Avoid situations of being alone with a youth at any time
  • Treat all youth with respect and only discipline members of your own group unless it is an emergency situation. Any concerns about the behavior of youth not under your care should be addressed to the conference staff
  • Chaperones are responsible for their youth at all times
  • Uphold all Chaperone and Participant guidelines

Sign and Submit

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Director of Catholic Education & Superintendent of Catholic Schools

Michelle Kroll
912-201-4122

Director of Youth Ministry

Caroline Ebberwein
912-201-4057

Executive Assistant to the Department of Catholic Education

Nancy Thornock
912-201-4121


Pray for us.