ERRC Release and Consent Form

2024 ERRC Release and Consent Form
Thank you participating in the 2024 East of the River Revival Youth Rally. The following release and consent form is a requirement for youth participation in the Youth Rally.

Please read the form carefully in its entiretity and fill the release form below completely and let us know if you give a go ahead for your child's participation in this year's Youth Rally. If the team, see incorrect data entered correctly and/or missing information, parents will be contacted to confirm the information.

All completed release forms and necessary information MUST be submitted by Sunday, September 22, 2024.
ERRC Release and Consent Form

Release and Consent Form
I, the undersigned, give permission for my son or daughter to attend the East of the River Revival Youth Rally activities. It is understood that reasonable caution will be taken by those persons in charge to prevent injuries.

In consideration of my child being permitted to participate in the ERRYR, I personally and on behalf of my child, hereby release The Archdiocese of Washington; Wilton Cardnial Gregory, Roman Catholic Archbishop of Washington; a Corporation Sole: the Catholic Youth Organization of Washington, DC and Metropolitan Area, Inc.; the Office of Youth Ministry; their employees; volunteers, the coordinators and chaperones of the East of the River Revival Committee; from any liability for injuries or damages arising or resulting from participation in the 7th Annual East of the River Revival Youth Rally, in and/or transportation to and there from.

In the event that I cannot be reached, I hereby grant permission for my son/daughter to be evaluated, diagnosed, treated and/or medicated in accordance with standard medical practice by licensed medical personnel. Permission is hereby granted to the ERRC, the Archdiocese of Washington to use the photographs and quotations of my son/daughter to assist in community awareness, educational efforts, related public relations purposed that may include brochures, posters, website and print media from the ERRC. My child agrees to abide by all rules and regulations as outlined in the Youth Code of Behavior. I understand that the Office of Youth Ministry and the Archdiocese of Washington will not be held liable if my child fails to cooperate with said regulations and that any infractions of the rules may result in an immediate dismissal from the East of the River Revival Youth Rally.
By signing below, I certify that I am the parent or legal guardian of the named minor and have authority to sign this form.
Parent/Guardian Signature*

First NameLast Name
Today's Date*

MonthDayYear
Youth Code of Behavior

Code of Behavior
The following guidelines will ensure a fun and safe experience for all of us:

1)       Participants will be given Credentials, which must be followed at all times. Masks are optional to wear but is highly reccommended.

2)       Participants are expected to attend all events on time and participate fully.

3)       Participants are expected to remain with an ERRC representative or assigned chaperone at all times.

4)       The possession of alcohol and illegal drugs is clearly prohibited and is cause for dismissal.

5)       The Parish/Organization are responsible for the overall actions of the participants.

6)       All participants, adults and youth will be held to the highest Christian standards of morality.

In the event that a behavior problem requires disciplinary action, an ERRC Member, Volunteer or designee, along with the individual’s chaperone, will address the situation and make the necessary decision.

As a member of __________________________ parish, a member of one of the Southeast Deanery and Partnering Churches, I understand and agree to the Youth Code of Behavior. I also understand and agree that my parents or legal guardian will be notified at the time of any infractions requiring my dismissal from the East of the River Revival Youth Rally and that an ERRC representative will call my parent/guardian to have me picked up from the ERRYR.
Youth Signature*

First NameLast Name
Today's Date*

MonthDayYear
Date
Select all that apply to your child's participation in this year's Youth Rally at the designated location. If "Other" is selected, please type "Participant."*

Youth ChoirYouth Liturgical DancersUsherMCLectorPlanning TeamOther
Church Name*
Year of High School Graduation*

Medical Information
My son/daughter is allergic to (medication/ food/other):*
Write N/A if there are no allergies.
My son/daughter must take the following medications and will be bringing enough medication for assigned condition. (Indicate medication, dosage, frequency, etc. Medication must be given to your parish adult chaperone to hold/administer):*
Write N/A if no medication is required
You should be aware of these special medical conditions and needs of my child. (Dietary, medical, mental health, walking assistance, bee sting allergies, other conditions) *
Write N/A if conditions does not apply.

Insurance Information
Please provide all necessary information about insurance
Insurance Carrier
Policy Carrier
Policy Number
Benefit/Plan/Group
Date of last Tetanus Booster
In case of emergency, notify*
Relationship to Youth*
Daytime Phone*

Area CodePhone Number
Evening Phone*

Area CodePhone Number

Parent/Guardian Signature
By singing below, I certify that I am the parent or legal guardian of the named minor and have autority to sing this form.
Parent/Guardian Electronic Signature*

First NameLast Name
Signature

Clear
Should be Empty:

2024 ERRC Release and Consent Form

ERRC Release and Consent Form

Youth Code of Behavior

Participant Emergency Information Form

Please provide all necessary information about insurance

Parent/Guardian Signature