St. Thomas' Episcopal Church
2000 Highland Avenue
Rochester, NY 14618
Please PRINT clearly!
Name of Youth: _____________________________
Date: ________________
Address: _________________________________________________
Home Telephone: ______________________
In order to promote healthy, loving and inclusive Christian community during our times together, the following norms have been developed for young peoples’ events:
All participants will abstain from the use or possession of tobacco products, illegal drugs and alcohol.
Electronic devices such as CD players and radios are not permitted.
Any interpersonal conflict among participants will be managed and resolved without the use of violence. No weapons of any kind are permitted at youth events. All participants agree to treat others with respect and kindness.
All participants agree to abstain from sexual activity during our times together.
As a community we are committed to affirming the dignity of every person, and so discriminatory behavior based on race, color, ethnicity, ancestry, gender, sexual orientation, physical disability or other personal attributes is not welcome among us.
All participants are required to remain with the group and the advisors during youth events.
My parent/s or guardian/s and I have read and understand the norms listed above, and I agree to live by them during youth events. I understand that refusal to abide by these norms may result in my being sent home immediately. Parent/s or guardian/s will be responsible for transporting participants home in the event of such a problem.
Participant’s signature: _______________________________________
Parent/s or Guardian/s signature:_______________________________
May we contact you (the youth member of the J/YPF) by e-mail?
If so, please provide your e-mail address:
And don’t forget to tell us if your address changes!
Is there anything else you want to tell us about your participation in the J/YPF?