NCYC Faith Mentor/Adult Chaperone Form

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Adult chaperones are needed to help make NCYC a safe and positive trip for our teens. Please note that this experience is geared towards teens and having too many adults can take away from that experience. If you are planning to attend as a chaperone you are agreeing to help the kids have a positive and faith-filled experience. You will be expected to be responsible for a group of 4-6 teens during the trip. You will also be expected to attend the NCYC fall meetings with the teens as well as one adult-only Faith Mentor meeting to discuss conference details.

If you feel that your child needs you to attend in order for them to be able to come due to behavioral, personal or other reasons please reach out to me so I can help to make this a great trip for both of you.

In order to attend, you will be required to fill out a background check and complete the Archdiocesan Safe Environment Training.

Thank you for volunteering to help with our youth!

Name *

Date of Birth *

YYYY

Phone number *

Email *

Address *

Shirt Size *

Your parish *

Emergency Contact Name and Phone Number *

Have you completed Safe Environment training with the Heart of Mary in the last year? *

Yes

I'm unsure

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