EYC Fall Weekend 2023
Friday, November 10 – Sunday, November 12, 2023
Chanco on the James, 394 Floods Dr, Spring Grove VA 23881

For questions contact Youth and Young Adult Missioner Megan Dern at mdern@diosova.org or 757-213-3393.
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Email *

Fall Weekend is an opportunity for youth to come together with friends from all over the Diocese and to spend time in retreat with God.

Youth in grades 6 through 12 are invited to join us for a weekend of camp fun and fellowship as we explore what it means to be in right relationship with God and others. The EYC Board has been exploring why faith matters today and is excited to share what they learned with the youth of the Diocese. During the weekend youth will be staying in conference housing and will have an opportunity to not only grow in their faith but also grow in community with activities around camp.

Fellowship is fun, spiritual, motivating, musical, and active... and it's at Chanco, so register now!!

Suggested packing list: bedding and pillow, toiletries, prescription medication in original case, seasonally appropriate clothing – bring layers including a swimsuit, sweater, hoodie, jacket, and raincoat, comfortable shoes, including one pair with closed toes, Bible, camera, musical instrument, books, flashlight, but spray.

Click here for complete packing list.

Check-in: 6:30 p.m. to 7:30 p.m. on Friday, November 10

Departure: 11:00 a.m. on Sunday, November 12

Retreat begins at 7:30 p.m. (Friday) and ends at 11:00 a.m. (Sunday)

Registration fee: $150.00

Registration deadline: Tuesday, October 31

* All participants must bring a photocopy of your medical insurance card and the completed and signed Medical Information and Release form to the event.

** Youth may only administer certain medications themselves at Diocese-sponsored events. Those medications are nebulizers, Epi-Pens, and birth control medication. All other medications must be provided to the on-duty nurse who will administer during the retreat.

Payment is required to complete your registration. No registrations will be accepted after Tuesday, October 31. Please register early as space is limited.

Partial scholarships are always available based on financial need. The typical practice is your family pays one third, your church pays one third, and the Diocese will pay one third. Click here for an application form. Send application to: Episcopal Diocese of Southern Virginia, 11832 Rock Landing Dr, Ste 100, Newport News, VA 23606-4231, or email to Youth and Young Adult Missioner Megan Dern at mdern@diosova.org.

*** No refunds can be issued once we are within 10 days before the event. For this event, refunds will not be issued after Tuesday, October 31. If after registration you are no longer able to attend this event please contact the diocesan office at 757-423-8287 so we can plan accordingly.

Participant first name *
Participant last name *
Participant email address *
Participant cell phone *
Participant home phone *
Participant home address *
Age *
Grade *
Church attended (and city/town) *
Preferred first name for name badge *
Pronouns *
Gender *
Housing: with which gender(s) would this participant feel comfortable rooming? *
Required
Please indicate any food preferences for this participant *
Required
Does this participant have any life-threatening allergies (please specify)? *
Have any of the following been diagnosed for this participant? (The next question will provide space for details.) *
Required
If any of the above were checked, please provide details on what accommodations this participant requires. *
Does this participant require ADA-compliant accommodations? If yes, please provide the relevant details. *
Anything else that we should know as we plan for you to participate? *
Parent/Guardian/Spouse name *
Parent/Guardian/Spouse email *
Parent/Guardian/Spouse cell phone number *
Emergency Contact name (if parent/guardian/spouse cannot be reached) *
Emergency Contact phone number (if parent/guardian/spouse cannot be reached) *
Release by Parent/Guardian for youth participation

I hereby grant permission for my dependent child, named as PARTICIPANT above, to take part in this Diocesan Event. I believe that she or he is capable of participating fully without causing injury to herself/himself or to the detriment of this community. I understand that if I or my dependent child does not live into the Community Covenant, she or he will return home at my expense and effort.
Release by adult participant

I believe that I am capable of participating fully without causing injury to myself or to the detriment of this community. I understand that if I do not live into the Community Covenant, I will return home at my expense and effort.
Photo/Video Release (required for all participants)

I understand that photos and videos may be taken at events sponsored by the Episcopal Diocese of Southern Virginia and Chanco on the James for publicity purposes, and I consent to the reproduction and distribution of my or my dependent child’s likeness.
 *
Required
Release, Assumption of Risk and Indemnity Agreement (required for all participants)

In consideration of being allowed to participate in activities for education/recreational purposes sponsored through Episcopal Diocese of Southern Virginia / Chanco on the James, which activities may include, without limitation, ropes course participation, zip lining, boating, archery, water activities, hiking, and service projects, hereafter called “Activities,” I agree that I understand the nature of these Activities and that I am or my child is in good health and in proper physical condition to participate in these Activities.  I agree to participate only while wearing the protective equipment required and to follow the instructions of the facilitators, and, if I believe it unsafe, to immediately discontinue participation.  I know that these Activities involve risk of serious bodily injury, including disability, and death, and damage or loss of personal property, and other known and foreseeable risks including, but not limited to, the risks of travel on roads or rough terrain by foot, conveyances, or other means, and on water; the risks arising from the failure or misuse of equipment; and the risks that injuries may occur in remote areas without adequate medical facilities. I realize that there may be other risks not known to me or not readily foreseeable, but I fully accept and assume all such risks, whether or not identified above, and I assume all responsibility for losses and damages which I may suffer as a result of my participation in these Activities.

I HEREBY RELEASE Episcopal Diocese of Southern Virginia / Chanco on the James, its members, representatives, officers, agents, employees, and each of them, and the owners and lessors of the property on which these Activities take place from all liability, claims, demands, losses, costs and damages arising or asserted to arise directly, indirectly, in whole or in part, from these Activities, whether resulting from negligence or otherwise and including rescue operations and will indemnify and hold harmless to all such matters.

I understand the nature of the above Activities, am familiar with the Participant’s or my experience and capabilities and believe her/him to be qualified to participate. I hereby personally accept and undertake, individually and in my own name, all of the obligations stated above, specifically including the release, assumption of risk, and hold harmless provisions to the parties of all liability, claims, demands, losses and damages suffered or alleged to have been suffered or incurred by the minor or to others resulting from injury to the minor. *
Required
Medical Release (required for all participants)

I understand that every effort will be made to contact Parent or Guardians before authorization of emergency treatment is given to dependent children. In the event I cannot be reached, or if immediate attention is required, I hereby authorize the adult leaders to appoint a licensed medical professional to provide treatment on my dependent child’s behalf and I agree to assume responsibility for all medical expenses.  I agree to hold harmless the Episcopal Diocese of Southern Virginia, adult leaders, event coordinators, Chanco on the James, designated medical professionals and the agents of said bodies in the event of accident or injury.

I consent and give permission for Diocese of Southern Virginia and Chanco on the James medical personnel and designated staff to administer authorized medication, first aid, and or emergency treatment to me and/or my child.  In addition, I give permission and consent to Diocese of Southern Virginia and Chanco on the James medical personnel and/or staff to provide or arrange transportation for me and/and or my child to select and to consent to health care providers evaluating, testing, treating, and or hospitalizing me and/or my child when, in their opinion, such services are needed.  I also consent to the release of medical records and medical information in order to secure medical care and/or payment for medical purposes.
 *
Required
Medication/Drug allergies – reaction and management/treatment
 *
Food allergies – reaction and management/treatment
 *
Other allergies – reaction and management/treatment
 *
List all medications to be taken routinely and as needed, including prescription and over-the-counter. Keep all medication in the original packaging that identifies the prescribing physician, medication name, dosage, and frequency of administration.
 *
Restrictions on activity
 *
Restrictions on diet – list foods and why
 *
Community Standards – for Youth and Adult Participants

The Episcopal Diocese of Southern Virginia is committed to providing a safe place for all Diocesan sponsored youth activities, while also helping participants explore and deepen their relationship with Christ, learn more about the Episcopal Church, and live into their Baptismal Covenant by serving the world around them. Adult and youth participants acknowledge and accept in writing that our community life is based upon mutual trust and respect for others, and adherence to the spirit and specifics of the following set of standards:

• I will choose to behave in a manner that respects the dignity of each person and will treat others as I wish to be treated. To this end, I will honor diverse viewpoints, act charitably, speak positively toward others and refrain from gossip, rumors, and triangulation. I will use respectful communication, refraining from use of foul language and gestures, and I will speak with honesty.
• I will help to create a safe and peaceful environment by not speaking or behaving in a violent or abusive manner. I will not engage in fighting, bullying, hazing, teasing, violence, or any form of threatening behavior or language.
• I will not possess or use fireworks, firearms, or weapons. Youth participants will also not possess lighters, pocket knives, candles, or open flames. Any candles or fires used for programing purposes should be monitored at all times.
• I will not use or possess non-sacramental alcohol, tobacco, e-cigarettes and other nicotine products, illegal drugs, nor will I abuse prescription medications. Youth will also turn over any medications to the individual responsible for medical care at the event.
• I will treat all personal and public property and facilities with care, refraining from acts of theft or vandalism and acknowledge that I will be held financially responsible for intentional damage to property.
• I will be present and on time for all planned activities and remain on the event property and with the community at all times. I will abide by curfews, quiet times, and physical boundaries set forth for the event.
• I will abide by the policy for cell phones and other electronic devices set forth at each event and will not engage in use of any electronic devices during programmed time.
• I will dress appropriately throughout the entire event, including wearing clothing appropriate to the activity. My undergarments will not be visible and my clothing will be free of inappropriate images and language.
• I recognize that sexual behavior, language, and activity have no place in this context and will refrain from engaging in such behavior. Sleeping quarters are to be private areas. All visitation and social time will occur only in common areas and never inside sleeping quarters.
• I will not engage in sexual misconduct of any kind, including use of pornography.
• I will not make alterations to my own or a peer's body, including piercing, tattooing, etc.
• I understand that visitors who are not registered participants of the event are not permitted.
• I will follow these and other guidelines set forth for the event and will respect the authority of the event leaders and the adults in charge.

During the course of diocesan events, youth and adults will be held accountable to this covenant. Should any problem arise, every effort will be made to resolve the issue with love and respect. Disregard for this covenant may result in dismissal from the event. Parents/guardians will be informed of any violation and will be responsible for any expenses incurred due to the violation. Adults in violation of said policies are responsible for any expenses incurred and must leave the event. Items not permitted by our policies will be confiscated. Authority to enforce these guidelines lies with the leadership teams responsible for the coordination of the event.

For Youth and Adult Participants: I have read the community standards and agree to live up to the standards described because I want to be safe, love others and represent Jesus at all times. I understand that my failure to do so may result in me being removed from the community and sent home at my expense.
 *
Required
Community Standards – for Parents/Guardians of Youth (not required for adult participants)

The Episcopal Diocese of Southern Virginia is committed to providing a safe place for all Diocesan sponsored youth activities, while also helping participants explore and deepen their relationship with Christ, learn more about the Episcopal Church, and live into their Baptismal Covenant by serving the world around them. Adult and youth participants acknowledge and accept in writing that our community life is based upon mutual trust and respect for others, and adherence to the spirit and specifics of the following set of standards:

• I will choose to behave in a manner that respects the dignity of each person and will treat others as I wish to be treated. To this end, I will honor diverse viewpoints, act charitably, speak positively toward others and refrain from gossip, rumors, and triangulation. I will use respectful communication, refraining from use of foul language and gestures, and I will speak with honesty.
• I will help to create a safe and peaceful environment by not speaking or behaving in a violent or abusive manner. I will not engage in fighting, bullying, hazing, teasing, violence, or any form of threatening behavior or language.
• I will not possess or use fireworks, firearms, or weapons. Youth participants will also not possess lighters, pocket knives, candles, or open flames. Any candles or fires used for programing purposes should be monitored at all times.
• I will not use or possess non-sacramental alcohol, tobacco, e-cigarettes and other nicotine products, illegal drugs, nor will I abuse prescription medications. Youth will also turn over any medications to the individual responsible for medical care at the event.
• I will treat all personal and public property and facilities with care, refraining from acts of theft or vandalism and acknowledge that I will be held financially responsible for intentional damage to property.
• I will be present and on time for all planned activities and remain on the event property and with the community at all times. I will abide by curfews, quiet times, and physical boundaries set forth for the event.
• I will abide by the policy for cell phones and other electronic devices set forth at each event and will not engage in use of any electronic devices during programmed time.
• I will dress appropriately throughout the entire event, including wearing clothing appropriate to the activity. My undergarments will not be visible and my clothing will be free of inappropriate images and language.
• I recognize that sexual behavior, language, and activity have no place in this context and will refrain from engaging in such behavior. Sleeping quarters are to be private areas. All visitation and social time will occur only in common areas and never inside sleeping quarters.
• I will not engage in sexual misconduct of any kind, including use of pornography.
• I will not make alterations to my own or a peer's body, including piercing, tattooing, etc.
• I understand that visitors who are not registered participants of the event are not permitted.
• I will follow these and other guidelines set forth for the event and will respect the authority of the event leaders and the adults in charge.

During the course of diocesan events, youth and adults will be held accountable to this covenant. Should any problem arise, every effort will be made to resolve the issue with love and respect. Disregard for this covenant may result in dismissal from the event. Parents/guardians will be informed of any violation and will be responsible for any expenses incurred due to the violation. Adults in violation of said policies are responsible for any expenses incurred and must leave the event. Items not permitted by our policies will be confiscated. Authority to enforce these guidelines lies with the leadership teams responsible for the coordination of the event.

For Parents/Guardians of Youth: I have read the covenant and have reviewed it with my child. I
understand that my child’s failure to adhere to the covenant may result in him/her/their being removed from the community and sent home at my expense.
Refund policy

By registering for this event I acknowledge and accept that no refunds can be issued once we are within 10 days before the event, and for this event refunds will not be issued after Tuesday, October 31.
 *
Required
All participants will receive the week before the event by email from Youth and Young Adult Missioner Megan Dern (mdern@diosova.org) an abbreviated Medical Information and Release form which must be printed out, completed and signed, and, along with a copy of the medical insurance card, turned in by the participant at registration at the start of the event.
Payment
The $150.00 registration fee may be paid by credit/debit card or by electronic funds transfer from your bank account at this link. Select "EYC Event Registration" for the payment description.

Payments by check or money order should be mailed to: Episcopal Diocese of Southern Virginia, 11832 Rock Landing Dr, Ste 100, Newport News, VA 23606-4231. Include the participant's name(s) and "EYC Event Registration" in the memo line.
Signature – for Youth and Adult Participants: typing your name here acts as your official signature and certifies that you have personally reviewed all of the information presented and will comply with our guidelines.
 *
Signature – for Parents/Guardians of Youth: typing your name here acts as your official signature and certifies that you have personally reviewed all of the information presented with your child and that you and your child will comply with our guidelines.
A copy of your responses will be emailed to the address you provided.
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