logo
DY





















NOTE: Information regarding transgender or nonbinary status will only be shared with Holle Tubbs (Youth Missioner) and retreat leadership.

Choosing to share this information helps us provide you with accommodations that best suit your needs. You will be contacted prior to the retreat by Holle Tubbs.

Part of our approach to COVID-19 safety is requiring all eligible participants to be fully vaccinated at least two weeks prior to the retreat. If your student is not currently fully vaccinated, you can save this form and upload the vaccination record once you have it.

If your student is medically ineligible to receive the COVID-19 vaccine, please use this field to upload physician documentation as proof.












Typing your name in the signature fields below acts as your official signature and certifies that you have personally reviewed the information presented and will comply with our guidelines.

Episcopal Youth Community Covenant


Below is the code of conduct we expect all youth to abide in while participating in all Diocesan Youth Events.


It is the policy of the Episcopal Diocese of Atlanta (the “Diocese”) that all events and activities conducted by the Diocese or on its property observe the following guidelines, which are to be interpreted in a manner consistent with the mission and doctrine of the Episcopal Church. 


  1. Responsible officials will model and promote behavior of and towards all Participants in keeping with the baptismal covenant of the Book of Common Prayer, including the covenant to respect the dignity of every human being.
  2. Aggressive behavior towards Participants by any person are not to be tolerated.
  3. Bullying, fighting, abusive or offensive language, and engaging in threats or coercion will not be tolerated.
  4. Any activity that presents a serious risk of personal injury or emotional harm to any Participant or other person is prohibited.
  5. Sexual advances towards or unwanted, inappropriate, or offensive touching of Participants is prohibited. (See Appendix A, Appropriate Displays of Affection in the “Diocesan Policies for the Protection of Children and Youth from Abuse”.)
  6. Weapons or items that appear to be or create the impression of dangerous weapons are prohibited.  Props for plays and games, kitchen utensils, utilitarian equipment and tools, and other items with a benign purpose that do not threaten Participants or create realistic and actual fear of harm are permitted if otherwise appropriate.  For example, a bow and arrow at an archery event or a cutting tool on a camping trip may be appropriate under all of the circumstances.
  7. Dorms are to remain the gender youth identify as.
  8. In organizing and directing events, Responsible Officials shall consider the personal privacy interests and desires of all Participants, consistent with the type of event involved, the nature of the facilities and activities, and the interests of others.
  9. Tobacco products are not permitted and shall not be used.  
  10. Participants below the legal drinking age shall not use or have possession of alcoholic beverages. (This guideline has no application to proper participation in communion.)                
  11. Illegal drugs and other controlled substances for which the person in possession has no prescription are prohibited.
  12. Age appropriate play or normal physical activities are permitted if they do not entail or threaten injury, offensive physical contact, or other offensive or improper conduct. (See Appendix A, Appropriate Displays of Affection in the “Diocesan Policies for the Protection of Children and Youth from Abuse”.  
  13. Discrimination on any basis prohibited by the Episcopal Church is not to be tolerated, consistent with other Diocesan policies.
  14. Responsible Officials shall apply these rules using common sense and good judgment, and not in an arbitrary or unreasonable manner.

For purposes of this policy, the following terms have the stated meaning:

  • “Participants” means children or youth participating in Diocesan events.
  • “Responsible Officials” means persons who are acting for or in cooperation with the Diocese or have any responsibilities or authority in connection with an event. 

I have read and commit to fulfilling the Episcopal Youth Community Covenant.


COVID-19 Safety


I acknowledge that the Diocese of Atlanta is taking the following precautions for the safety of all camp staff and retreat participants:

  • All eligible participants are required to be fully vaccinated at least two weeks prior to the retreat weekend.
  • Any medical exemptions from vaccination must be submitted with documentation from a physician.
  • Participants with a documented medical exemption must submit proof of a negative COVID test, taken within three days prior to Happening.
  • Participants are required to wear a well-fitted mask covering both the nose and mouth when indoors or in close proximity to others.
  • We will practice physical distancing between cohorts (family groups) at all times.
  • Activities will be outdoors when possible.

*You can reference CDC guidelines here for more detail.

I have read and will comply with these COVID-19 safety policies.


Permission, Medical, and Liability


As parent or guardian of this child, I attest that he/she is in good health and has no physical, mental, or emotional reason that would prohibit him/her from participating in the retreat. I understand that every precaution has been taken to assure the good health and safety of each participant.


Therefore, I waive any liability of the Diocese of Atlanta or it’s representation from injury or death while attending the retreat. I give my permission to the Diocese of Atlanta to hospitalize, secure treatment for, and to order injection, anesthesia or surgery for my child, and to have my child medically treated by a licensed physician, nurse, or hospital staff during the time period described.


I also understand that the Diocese of Atlanta does not provide medical insurance for expenses of these treatments. Therefore, all expenses would be the responsibility of the family of the child requiring treatment.


Photo Release


I hereby give my consent to all photos video taken of my child by the Diocese of Atlanta. I understand that any such photos, or videos become the property of the Diocese of Atlanta and may be used by the parish or Diocese with their consent, for, instructional or promotional purposes determined by the Diocese of Atlanta in broadcast and media formats now existing or created in the future.


Housing


In conformity with the policies and doctrine of the Episcopal Church, the Office of Youth Ministries houses participants in accordance with their expressed gender identity.


Safe bathroom/shower facilities will be provided by gender (or specific times will be assigned to the use of a single facility). Participants will remain fully clothed while in common areas at all times and change in private areas.


By executing this registration, you acknowledge the existence of this policy and consent to its application at the diocesan youth overnight event, during the period when your family member is at a diocesan youth overnight event.


If you wish to discuss the application of this policy, please contact Holle Tubbs (Youth Missioner) at htubbs@episcopalatlanta.org.

Payment


The cost for this retreat is $150. If you need financial assistance, please email Holle Tubbs (Diocesan Youth Missioner) at htubbs@episcopalatlanta.org


Payment is not required for adults or college students attending as a chaperones.

Payment Information






Retreat Packing List

  • Mask(s)* (please see below for details)
  • Hand sanitizer
  • Clothes you can layer for warmth  
  • Close-toed shoes
  • Instrument (if you play)
  • Water bottle
  • Sheets for a twin bed OR sleeping bag/blanket
  • Pillow
  • Toiletries
  • Towel
  • Pajamas (top and bottom)
  • Themed attire for the Dance 
  • Prescription medication as needed
  • Cabin snack (optional)
  • You can bring your phone but it will stay in your cabin for the duration of the weekend

*Masks should meet the following CDC criteria:

  • Have two or more layers of washable, breathable fabric
  • Completely cover your nose and mouth
  • Fit snugly against the sides of your face
  • Have a nose wire to prevent air from leaking out of the top of the mask

Please note that we will have disposable masks if needed, but we're asking everyone to bring their own to avoid wasting resources!