Applicant Information

Contact Details

First Name

Last Name

Phone

Preferred Name (if different than legal name)

Parent/Guardian Email

Which Happening # did you attend?

In which Diocese?

Have you served on a Happening Team before?

It is currently our policy that all medically eligible retreat participants be fully vaccinated against COVID-19. Please upload an image of the applicant's COVID-19 Vaccination Card.

Are you a Youth, College Freshman, or Adult (college sophomores or older)?

YouthCollege FreshmanAdult

T-shirt Size

Date of Birth

Grade during 2022-23 school year

Address Line 1

Address Line 2

City

State

Zip Code

Church/Parish

Priest or Youth Leader's Name

Priest or Youth Leader's Email

Information regarding transgender/non-binary status on this form will be shared only with the Director of Youth and Young Adult Ministries and the adult leadership of the youth overnight event. Choosing to share this information helps us provide accommodations that best suit your needs. The Diocesan Youth Missioner (Holle Tubbs) will follow up with you prior to the retreat.

Gender

Pronouns

Do you play an instrument?

YesNo

If so, which instrument?

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

Emergency Contact Phone (Alternate)

Insurance Information

Insurance Name

Insurance Group Number

Insurance Policy

Insurance Phone

Please list any medications you will be bringing and how often you need to take them

Please list any food allergies or special dietary needs

Please list any parish activities in which you participate:

Please list any diocesan activities in which you participate:

Why do you want to serve on the Happening Team?

What are some gifts or skills you will contribute to the Happening Team?

If there is a particular position on Team that you would like to be considered for, please tell us which position and why:

Do you feel called to give a talk?

YesNo

Why do you want to give the talk(s) you selected?

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.

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.
Aggressive behavior towards Participants by any person are not to be tolerated.
Bullying, fighting, abusive or offensive language, and engaging in threats or coercion will not be tolerated.
Any activity that presents a serious risk of personal injury or emotional harm to any Participant or other person is prohibited.
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”.)
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.
Dorms are to remain the gender youth identify as.
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.
Tobacco products are not permitted and shall not be used.
Participants below the legal drinking age shall not use or have possession of alcoholic beverages. Of course, this guideline has no application to proper participation in communion.
Illegal drugs and other controlled substances for which the person in possession has no prescription are prohibited.
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”.
Discrimination on any basis prohibited by the Episcopal Church is not to be tolerated, consistent with other Diocesan policies.
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.

Applicant, by typing your name below, you are stating that you have read and will commit to fulfilling the Episcopal Youth Community Covenant.

First Name

Last Name

Housing Policy

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 (Diocesan Youth Missioner).

Permission, Medical & 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 Happening. 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 Happening. 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.

Parent/Guardian, by typing your name below, you are attesting that you consent to the above paragraph (Permission, Medical & Liability)

First Name

Last Name

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.

Parent/Guardian, by typing your name below, you are attesting that you consent to the above paragraph (Photo Release)

First Name

Last Name

COVID-19 Participation Risk & Vaccination Acknowledgement

By signing below, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I, or others, may be exposed to or infected by COVID-19 while attending this event, and that such exposure or infection may result in personal injury, illness, disability, or death.

I understand that in order to attend this event I must be free from COVID-19 symptoms. Should symptoms develop while at the event, I will be separated into quarantine and must be picked up or depart immediately. I further voluntarily agree that EYCDIOATL leadership may monitor me for symptoms of COVID-19 (including but not limited to fever of 100.4 degrees Fahrenheit or higher, shortness of breath, chills, dry cough, sore throat, and muscle aches).

I will immediately notify EYCDIOATL leadership if I become aware of any person with whom I have had contact: exhibits any symptoms of COVID-19; is advised to self-isolate, quarantine, or has tested positive for COVID-19 prior to, during, or within two weeks after my participation in this event.

I hereby attest that I (or the applicant) is or will be fully vaccinated against COVID-19 by the beginning of the retreat (if medically eligible) or, if not medically eligible to be vaccinated, will comply with the Diocese of Atlanta's COVID-19 Overnight Retreat Safety Policy (testing negative for COVID-19 at the beginning of the retreat, remaining masked the entire time).

First Name

Last Name

Payment

Payment for this retreat can be made after the applicant is accepted onto the Happening Team (an email with the link will be sent with the acceptance letter).

Applicant Information

Episcopal Youth Community Covenant

Applicant, by typing your name below, you are stating that you have read and will commit to fulfilling the Episcopal Youth Community Covenant.

Housing Policy

Permission, Medical & Liability

Parent/Guardian, by typing your name below, you are attesting that you consent to the above paragraph (Permission, Medical & Liability)

Photo Release

Parent/Guardian, by typing your name below, you are attesting that you consent to the above paragraph (Photo Release)

COVID-19 Participation Risk & Vaccination Acknowledgement

Payment

Thank you for applying to serve on our Happening 76 Team! Final decisions on Team applications will be announced by August 26.