Welcome to Church to the Epiphany
Jan 5, 2018
Please fill out the registration below. Payment for registration can be done here!
In many cases, our staff and volunteers are not familiar with the medical, physical, and/or emotional history of each participant.
Please share ANY information relating to the participant in detail. BE AS SPECIFIC AS POSSIBLE.
As parent and/or legal guardian I remain legally responsible for any personal actions taken by the above named minor. I agree on behalf of myself, my child named herein, or
our heirs, successors, and assigns, to hold harmless and defend the Catholic Diocese of Richmond, its employees and agents, chaperons, or representatives associated with this
event from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in
connection therewith, and I agree to compensate the Diocese, its employees and agents and chaperons, 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 the negligence of the Diocese.
I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. In the event of any emergency, I hereby
give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In
the event of an emergency, if you are unable to reach me at the above numbers I give permission for the noted emergency contact to be notified. I will not hold the Diocese of
Richmond responsible for authorizing any medical treatment beyond necessary transportation to the hospital.
Youth participants must read, understand, agree, sign and return this sheet with the Medical Information and Release
form. Each participant is expected to adhere to the following principles while at the Diocesan Youth Conference 2018:
SHOW LOVE AND RESPECT FOR GOD:
✓ Pray daily for self and others.
✓ Participate in opportunities to receive the Sacraments.
✓ Participate in the sessions, activities, and prayer experiences.
✓ Be open, flexible, and have a servant’s attitude.
✓ Represent God in your words and actions.
SHOW LOVE AND RESPECT FOR SELF:
✓ Remember that you are the Temple of the Holy Spirit. Present yourself accordingly.
✓ No alcohol, drugs, or smoking will be tolerated during the weekend.
✓ Dress with modesty. Bare mid-drifts, spaghetti straps, short-shorts, low cut tops, or guys without shirts are not
permitted during the weekend.
✓ Any music you bring and listen to should glorify God.
✓ Drink plenty of water, obey sleeping times, and make sure you eat all meals. This will allow you to fully participate
and not be tired.
✓ If you must leave an activity, adult chaperones should accompany you since they are responsible for you.
SHOW LOVE AND RESPECT FOR OTHERS:
✓ All words and actions should be those of Christ to build up others and not injure.
✓ Make sure that your actions during the activities do not distract others from hearing, seeing, or praying.
✓ Be safe. No horseplay or other potentially harmful actions. Leave pocketknives, lighters, or other hazardous
materials at home.
✓ No teenagers are allowed to drive to or from the conference due to limited parking and liabilities.
✓ Under no circumstances can a youth be in the room or hall of a member of the opposite sex.
✓ Allow others to sleep. “Lights Out” means that it is time to go to sleep. Do not be in the showers or halls after
✓ No outside or unregistered visitors at the conference will be permitted.
✓ The facility must remain clean and undamaged. Otherwise, you will personally be responsible to pay for the
damage. Don’t bring food or drinks to the rooms and pick up trash if you see it.
✓ Any damages caused by the participant will be charged to the participant.
I have read, understand, and agree to the above principles. Any violation of the above principles may result in
immediate dismissal from the Diocesan Youth Conference and participants will forfeit their registration fee.
To pay for registration, please use this link: https://epiphanychurch.weshareonline.org/DiocesanYouthConference
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