NCYC 2025 Application

National Catholic Youth Conference (NCYC) 2025 Application

November 20-23, 2025
Teen Information
This is a two-part application process.
Part 1: Complete and submit this form.
Part 2: Email your essay to youthministry@stjoseph-libertyville.org.

We have a limited number of spots available, so we encourage you to apply soon. All applicants will hear from us by the end of September regarding acceptance.
Teen First and Last Name*

First NameLast Name
Teen Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Teen Cell Phone
Teen Email Address
example@example.com
Teen Birthday*

MonthDayYear
Date
Teen's Age on November 23, 2025*
Teen School*
Teen Grade*
Teen T-Shirt Size (Adult Sizes)*
If you currently belong to a parish/church community, please write which one.*
Example: St. Joe's

Parent/Guardian & Emergency Contact Information
All communications will be sent to Parent/Guardian #1.

Please check this box for Parent/Guardian #2 to also receive communications.
Parent/Guardian #1 First and Last Name*

First NameLast Name
Parent/Guardian #1 Relationship to Teen*
Parent/Guardian #1 Phone Number*
Please enter a valid phone number.
Parent/Guardian #1 Email Address*
example@example.com
Parent/Guardian #2 First and Last Name*

First NameLast Name
Parent/Guardian #2 Relationship to Teen
Parent/Guardian #2 Phone Number*
Please enter a valid phone number.
Parent/Guardian #2 Email Address*
example@example.com
Emergency Contact Information

In case of emergencies, we will attempt to contact the parent/guardians first. In case we cannot get ahold of either parent/guardian, please write an additional emergency contact below.
Emergency Contact First and Last Name*
Please ensure this is not one of the Parent/Guardians listed above.
Emergency Contact Phone Number
Emergency Contact Relationship to Teen

Medical Information
Please list any medical allergies, significant medical history, current medications, and/or dietary restrictions.*
Medical Insurance Company*
Insurance Number*
Teens will be responsible for taking their own medications. All medications must be in their original container/packaging with complete instructions. Please list below all medications you authorize your teen to take and instructions for dispensing each. Include the name of the drug, frequency, and any special instructions.
Example: Melatonin (as needed)
Medical Release

In the event that the undersigned, or my/our authorized physician, cannot be reached and, in the judgment of the youth ministry leaders or his/her designee, there is a necessity for immediate examination and/or treatment of my/our child, I/we hereby request and authorize youth ministry personnel to obtain for my/our child such medical services as are deemed necessary. I/we agree to assume the medical and liability insurance coverage and costs for any diagnosis/treatment and/or for medication deemed necessary. I/we understand that it may be necessary for my/our child’s medical condition to be disclosed to youth ministry personnel and/or medical providers, and I/we expressly consent to such disclosure.
Medical Release - Parent/Guardian Signature*

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Today's Date*

MonthDayYear
Date

Teen Expectations Agreement
I, {teenFirst143}, a St. Joseph NCYC Teen, agree to enter into this contract with Parents/Guardians and the St. Joseph NCYC Group Leaders.

As a representative of St. Joseph Catholic Church at the National Catholic Youth Conference (NCYC), I understand that my words, actions, and choices reflect not only on myself, but also on my parish, my family, and my faith. I commit to conduct myself in a manner that honors God, respects others, and promotes a safe and positive environment for all participants.

Expectations

I will:
- Treat everyone with respect, courtesy, dignity, patience, and integrity.
- Follow the directions of NCYC leaders, parish chaperones, and supervising adults at all times.
- Remain with my assigned group and participate fully in all scheduled activities.
- Respect curfews and quiet times.
- Treat property, facilities, and belongings (my own and others’) with care. I will report any damage I cause to an adult immediately.
- Respect safety and immediately report unsafe behavior or hazards to a chaperone.
- Follow the event dress code and the cell phone/technology policies required by my parish.
- Avoid any behavior that poses a health or safety risk to myself or others.
- Participate in all required pre-trip meetings, fundraisers, and post-trip activities.
Prohibited Items and Behaviors

The following are strictly prohibited and will result in immediate removal from NCYC at my parent/guardian’s expense:
- Tobacco products, alcohol, marijuana, vaping devices, or illegal drugs
- Weapons of any kind
- Inappropriate or offensive videos, images, or reading materials
- Any item or action intended to harm myself or others
I understand that parish leaders have the right to search my belongings if they reasonably suspect I have prohibited items or materials.

I also understand that I may be sent home for engaging in unsafe, destructive, or irresponsible behavior, including but not limited to horseplay, harassment, theft, property damage, or conduct that disrupts the event.

Acknowledgment

I have read and understand this Code of Conduct. I agree to follow it during all parts of NCYC, knowing that failure to comply may result in my immediate dismissal from the event at my parent/guardian’s expense.
NCYC Teen Signature*

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Parent/Guardian Signature*

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Archdiocese of Chicago Agreement
CATHOLIC BISHOP OF CHICAGO, A CORPORATION SOLE, AND ST. JOSEPH LIBERTYVILLE RELEASE OF ALL CLAIMS

In consideration for being accepted by St. Joseph Libertyville, I (we) being 21 years of age or older, do for myself (ourselves and for and on behalf of my (our) child-participant (if said child is not 21 years of age or older) do hereby release, forever discharge and agree to forever hold harmless St. Joseph Libertyville, employees and agents thereof, from any and all liability, claims, demands for personal injury, sickness, death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned or the child participant resulting from said child's participation in the St. Joseph Libertyville NCYC, (including travel between the child's home and the event location, activities during the event, and anytime spent at the event.)

Furthermore, I (we) (and on behalf of our child-participant if under the age of 21 years) hereby assume all risk of said personal injury, sickness, death, damage, and expenses as a result of participation as above set forth. Further, authorization and permission are hereby given to St. Joseph Libertyville to furnish any necessary transportation, food, and lodging for this participant. The undersigned further agrees to hold harmless and indemnify St. Joseph Libertyville, employees, and agents, for any loss, claim, liability, damage, including property damage or injury whatsoever incurred by child-participant as a result of the negligent, willful, or intentional acts of said participant, including reasonable attorney's fees and other expenses incurred attendant thereto.

If the participant has not attained the age of 21 years:

I (we) am (are) the parent(s) or legal guardian(s) of this participant, and hereby grant my (our) permission for him (her) to participate fully in said St. Joseph Libertyville NCYC, and hereby give my (our) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including, but not limited to emergency surgery or medical treatment, and assume the responsibility of all medical bills. I give permission for my child to be transported in privately owned vehicles or in public transportation and for the release of medical records to an attending physician in case of illness. Further, should it be necessary for the participant to return home due to disciplinary action, for medical reasons, or otherwise, I (we) hereby assume all hotel and transportation costs. I (we) are aware of no physical, mental, or emotional problems, which would limit participation in the St. Joseph Libertyville NCYC trip. I (we) am (are) fully aware of the nature of the St. Joseph Libertyville NCYC trip.

Neither the Catholic Bishop of Chicago, A Corporation Sole, nor St. Joseph Libertyville will be liable for loss or damage to property of participants prior to, during, or following the trip due to theft, fire, accident or any other cause beyond its control.
MEDIA/PHOTO WAIVER: I hereby authorize and give my full consent to St. Joseph Libertyville to publish any and all photographs, video, or audio in which I/my child will appear before, during, and after attending NCYC in relation to the St. Joseph Libertyville NCYC trip.
By signing below, the NCYC Teen along with their Parent/Guardian, agrees to the terms of this contract.
NCYC Teen Name*

First NameLast Name
NCYC Teen Signature*

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Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

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Today's Date

MonthDayYear
Date

Payment
St. Joseph Libertyville must pay the full balance to purchase and reserve our tickets, lodging, and transportation. If you back out, we lose hundreds of dollars. For this reason, payments cannot be refunded unless someone else fills your spot.

I understand that the payments are non-refundable after the payment deadline unless another person is found to fill my spot (taken first from the waiting list).

Please note: not all applications may be accepted. If you are accepted, you are expected to complete the payment within a week of being accepted.
Parent/Guardian's Signature*

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Today's Date*

MonthDayYear
Date

Thank You!

Thank you for completing the registration forms for NCYC. Please complete part two of the application process by sending an email to youthministry@stjoseph-libertyville.org.
Should be Empty:

National Catholic Youth Conference (NCYC) 2025 Application

Teen Information

Parent/Guardian & Emergency Contact Information

Emergency Contact Information

Medical Information

Teen Expectations Agreement

Archdiocese of Chicago Agreement

Payment

Thank You!