Youth Waivers | The Episcopal Church in Colorado

2026-2027 Youth Waiver

2026-2027 Youth Consent for Excursion, Trip, or Program Participation Release Waiver and Indemnification Form for The Episcopal Church in Colorado

Events: All diocesan youth events, retreats, and YES Trips Waiver Year:Events/trips between September 2026-August 2027 Event Locations: Cathedral Ridge, The Episcopal Church in Colorado Properties, Off Site Locations for YES Trips & YOCO Meetings **Note: please complete a separate waiver for each youth participant from your family**

Youth Participant's Full Name(Required)

Youth Participant’s Home Church(Required)

Youth Participant’s Youth Leader & Priest(Required)

Birth Date(Required)

Grade as of Fall 2026(Required)

6th Grade

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

Youth Participant's Preferred Pronouns(Required)

he/him/his

he/them

she/her/hers

she/them

they/them/theirs

other

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Consent(Required)

I agree

I/we understand that certain rules of conduct have been established for all participants during this retreat and I/we assume responsibility for the youth’s actions during this retreat and the youth’s compliance with the rules. I/we agree that, in the event the youth violates the established rules for youth during this trip:

I/we understand that certain rules of conduct have been established for all participants during this event/trip and I/we assume responsibility for the youth’s actions during this event/trip and the youth’s compliance with the rules. I/we agree that, in the event the youth violates the established rules for youth during this event/trip:
In the event of repeated violations or a serious violation of the established rules by the youth, I/we understand that I will be called and I agree to talk with a member of the adult leadership team concerning the youth’s actions and behavior and I/we further understand, agree that I/we will bring the youth home at my/our expense.

I/we further understand and agree that the youth will, during part or all of the event/trip, travel by private vehicle or rented vehicle and I/we hereby consent thereto and specifically: (1) waive any and all claims of any sort or nature I/we may have against the owner and/or driver of any such private or rented transportation for any personal injury, bodily injury or death and for any property damage, regardless of the cause thereof, and (2) agree to hold harmless and indemnify the owner and/or driver of any such private transportation from any and all claims or demands of any sort or nature which may be asserted by or on behalf of the youth for any personal injury, bodily injury, death or property damage, regardless of the cause thereof.

I/we waive any claim against The Episcopal Diocese in Colorado, YES Trips, or any individual church within The Episcopal Church in Colorado, their sponsors, agents, officers, directors, servants, volunteers and employees and hereby release them from any responsibility and liability for any personal or bodily injury, death or property damage that my child may sustain during the above listed activity, event, or trip. I/we agree to indemnify, save and hold the church and all the persons described above, harmless from any claim, demand or cause of action of whatsoever nature or kind asserted by or on behalf of the youth for any personal or bodily injury, death or property damage sustained by the youth during the event/trip and the youth’s participation therein.

I/we assume all liability for and agree to save, indemnify, defend and hold The Episcopal Diocese of Colorado, YES Trips, or any individual church within The Episcopal Church in Colorado their agents, officers, directors, servants, volunteers, and employees, harmless from any and all claims or demands of any sort or nature for damage or injury to persons or property caused by the actions, omissions or negligence of the youth.

Conduct Covenant(Required)

I agree.

We, parents and youth, understand that for a successful, fun, and safe event/trip every participate must fully comply with this community covenant and always act with a good Christian spirit of behavior. We agree to the following covenant of behaviors, as shown by our signatures below:

Youth Event/Trip Covenant (Rules)

• I will respect the dignity of every human being
• No vulgar language or swear words will be allowed
• I will participate fully in every activity and task throughout this event/trip
• I will listen carefully to instructions, safety procedures, and follow them
• I will ask questions anytime I’m not sure what I should be doing
• Quiet will be maintained for an 8-hour period every night
• I will be in my sleeping space during quiet time with my phone turned off
• No use of tobacco products, alcohol, marijuana, or illegal drugs is allowed
• I understand there is a strict no bullying policy
• No sexual behavior of any kind is allowed
• No sexual harassing language or overly sexualized speech is allowed
• Exclusive relationships that exist prior to this event/trip need to remain private to allow all participants the openness to build new relationships and community
• I will speak to an adult leader if there is a misunderstanding or issue that arises with another person I interact with on this event/trip
• I will eat the healthy food provided me (medical dietary restrictions will be met)
• I will stay hydrated by drinking enough water
• I will take my prescription medication, if applicable
• I will use sunscreen when weather warrants the protection
• If I am feeling unwell I will let the nurse/medical person know right away
• I will not leave the premises I am on

Youth Events & YES Trips Cell Phone Policy

• I am solely responsible for my cell phone and will keep it in a safe place while I am sleeping and during the day.
• I understand that cell phones are personal property and I will not take or use another person’s phone
• I will leave my cell phone in the car or my personal space while engaged in event activities or trip service work. I understand there may be events where cell phones are not permitted at all
• My cell phone may be used for taking pictures, listening to music at approved times, and in case of an emergency
• I will never take a picture, post or tag another person’s photo on any social media without that person’s express permission
• If I use my cell phone when I should be working, participating in worship, or in any other way interacting with the group I will be given a warning
• If I persist in inappropriate usage my phone it will be held by event/trip leadership for the remainder of the event/trip, parents will be notified
• The Episcopal Church in Colorado & YES Trips are not responsible for lost or damaged phones
I understand all rules communicated to me by the Event or YES Trips leadership or adults I interact with at activities or worksites, are in place for my safety and the safety of the group. I will comply by these rules and pledge to keep myself and my fellow participants safe.
I/We understand that if I am unable or unwilling to participate in a safe and constructive manner, my parents/guardians will be contacted and appropriate actions will be taken.

By clicking I agree, I/we agree to all covenant and policies of The Episcopal Church in Colorado & YES Trips:

Photo Waiver - I give permission to use my child's image in the following formats:

During events/trips youth, leaders, and people we work with may take pictures of the group. At the end of the event/trip leaders will collect and create a digital folder with as many pictures shared with us and use these photos to create event/trip reports, videos, articles, and social media posts to share about the event/trip. Parents and youth understand that photos may also be shared by youth on their own social media accounts. By accepting, you agree to the use of photos in the above-mentioned ways and that you/your youth may be included in the photos. If you have a concern about your youth being included in event/trip photos please share that concern below.

I/we agree(Required)

Yes

Concerns

Emergency Contacts

Parent/Guardian 1 Name:(Required)

Parent/Guardian 1 work phone:(Required)

Parent/Guardian 1 cell phone:(Required)

Parent/Guardian 2 Name:

Parent/Guardian 2 work phone:

Parent/Guardian 2 cell phone:

Emergency Contact (other than parent/guardian):(Required)

Emergency Contact Phone Number(Required)

Relationship to participant(Required)

Medical Information and Authorization

Doctor's Name(Required)

Doctor's Phone Number(Required)

Does your youth have any allergies? (include all; food, environmental, insect, or medicine. Please include symptoms of exposure):(Required)

Does your youth have any physical, social, emotional, or psychological conditions or triggers?(Required)

Does your youth have any dietary restrictions?(Required)

Will your youth be taking prescription medication on this trip? If NO, move onto next section.(Required)

Yes

Medicine 1:

List each medication and include the condition medicine is prescribed for, the dosing amount and instructions and date and time of last dose before leaving for this retreat (ex. Metformin for Diabetes 2, 1 tablet twice a day with breakfast and dinner. Last dose taken today at breakfast):

Medicine 2:

Medicine 3:

Medicine 4:

Medicine 5:

Does your youth take an over-the-counter medication on a regular basis?(Required)

Yes

If yes, what over-the-counter medicines:

Ibuprofen (Advil, Motrin) / Acetaminophen (Tylenol) **We will not give youth aspirin.

Benadryl/Claritin for allergic reaction

Ointments such as: Cortisone cream, Aloe Vera, Antibiotic Cream

Antacids, Imodium, Pepto Bismal, Milk of Magnesia

Other (please specify)

(check all that are permitted)

Permission to give over-the-counter medicines:(Required)

Yes

**Youth will be reminded to use sunscreen and insect repellent but are ultimately responsible for the application of both. Severe sunburn can be cause for youth to be sent home as it is a medical condition with inherent risks.

Instructions about medications

• All medications, either prescription or over the counter, will be collected by the event/trip nurse or medical person when we leave • Please put your youth’s medications in a zip lock bag clearly marked with their name • All medications need to be in the original prescription/OTC bottle. No pill boxes or daily containers allowed • Upon arriving at the event/trip location all medications will be stored and dispensed by the trip nurse or medical person and kept in a secure location • Each day youth will come to the nurse/medical person to take their medications • A log will be kept of all medication taken by the youth • If your youth needs a reminder to take their medications please email event/trip leadership with specific instructions • Thank you for helping us to keep everyone healthy and safe!

I understand these policies and will comply to all of them.(Required)

I Agree

If your youth needs a reminder to take their medications, please indicate with any notes here:

IF YOUR CHILD STARTS A NEW MEDICATION BETWEEN NOW AND THE RETREAT, PLEASE MAKE SURE WE KNOW ABOUT THE NEW MED, HOW AND WHEN TO DISPENSE IT, AND ANY POSSIBLE SIDE EFFECTS IT COULD CAUSE, THANKS!

Emergency Room or Urgent Care

In the event of an emergency, I understand that every effort will be made to contact me as soon as possible, and that efforts to contact me will continue even as care or treatment is administered. If needed, which is your preference: Urgent Care or Emergency Room. An effort will be made to meet this request if possible.

Please make a selection:(Required)

Emergency Room

Urgent Care

I hereby authorize the adult leader(s) named below to act as agent for me and to seek and consent to any medical, dental, or surgical evaluation and treatment deemed necessary by a licensed medical professional.

Adult Leader permitted to act as my agent:(Required)

Adult Leader permitted to act as my agent:

Insurance

Participant's Name

First Last

A PHOTO COPY OF YOUR INSURANCE ID CARD IS REQUIRED TO BE SUBMITED WITH THIS FORM

Max. file size: 64 MB.

Signature Page- I understand these policies and will comply to all of them.

Parent/Guardian 1 Name(Required)

First Last

Date(Required)

Parent/Guardian 2 Name

First Last

Date

Untitled

2026-2027 Youth Waiver

2026-2027 Youth Consent for Excursion, Trip, or Program Participation Release Waiver and Indemnification Form for The Episcopal Church in Colorado

Photo Waiver - I give permission to use my child's image in the following formats:

Emergency Contacts

Medical Information and Authorization

Instructions about medications

IF YOUR CHILD STARTS A NEW MEDICATION BETWEEN NOW AND THE RETREAT, PLEASE MAKE SURE WE KNOW ABOUT THE NEW MED, HOW AND WHEN TO DISPENSE IT, AND ANY POSSIBLE SIDE EFFECTS IT COULD CAUSE, THANKS!

Emergency Room or Urgent Care

I hereby authorize the adult leader(s) named below to act as agent for me and to seek and consent to any medical, dental, or surgical evaluation and treatment deemed necessary by a licensed medical professional.

Insurance

Signature Page- I understand these policies and will comply to all of them.

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