Confirmation Retreat ADULT CHAPERONE Registration

This registration form is for adult chaperones attending one of the Confirmation retreats in Spring 2020.

All fields marked with a red asterisk (*) are required.

Select Confirmation Retreat

Please select ONE *

Saturday, March 7, 2020 at Christ Church, Pompton Lakes

Saturday, April 4, 2020 at St. James, Upper Montclair

Full information about the costs and deadlines for each of these Confirmation Retreat options is available on the Confirmation page.

Participant Information

First Name *

Last Name *

Church Affiliation *

Birth date *

Month

Day

Year

Gender *

Male

Female

Email *

Cell Phone *

Street Address *

City *

State *

Zip code *

Any chronic conditions, food allergies, dietary restrictions or other issues we should know about

Emergency Contact

Name *

Relationship *

Phone *

Safeguarding God's Children

Have you completed Safeguarding God’s Children training within the last 5 years? *

Yes

Date of training

Month

Day

Year

Upload copy of certificate

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png bmp pdf.

Diocese of Newark Program Community Covenant

(Responsibilities & Regulations)

Our primary goal is to provide a safe, healthy, Christian environment for all participants. This covenant applies to ALL participants (youth, adult sponsors, clergy, speakers, etc.) Personal responsibilities (ALL ages & roles): To seek and serve Christ in all people. Respect the dignity of every human being and to work together as a community for the benefit of the group. There will be no alcohol, illegal drugs, knives (this includes pocket/jackknives) or weapons brought on the premises for any reason. Possession of sexually explicit materials is prohibited. In addition inappropriate, offensive, or sexually explicit communications or statements are prohibited. Smoking or using other tobacco products is prohibited in all buildings, meeting rooms and sleeping areas. Smoking by youth is prohibited. No pets/animals are allowed except trained service dogs. Participants must respect personal and public property. Repair costs for damages incurred to property will be billed to the individual responsible for the damage. Participants are asked to refrain from making noise in common areas and sleeping rooms during specifically named times with a named curfew for each program. To protect the safety of all participants at the event, no socialization between boys and girls is allowed in the participants’ sleeping areas or rooms. Adult chaperones and group leaders are responsible for enforcing the rules as stated. Violators of this Covenant may be asked to leave and/or be sent home. These rules are not subject to interpretation and each participant is expected to follow them without exception. If not able to attend the entire event, please do not attend.

Required *

I agree with the responsibilities and regulations of the Diocese of Newark Program Community Covenant

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Diocese of Newark Program Community Covenant