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NCYC Chaperone Registration Form
2025 NCYC Chaperone
Date of Registration
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MM slash DD slash YYYY
CONTACT INFORMATION
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Address Line 2
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Allergy/Medical Concerns
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T-Shirt Size
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Diocesan and Parish Policies
We, at the Catholic Diocesan of Orlando and our parish St. Catherine of Siena, are committed to provide our children an vulnerable population a safe environment. All chaperone must check and take the Safe Environment training with the Diocese of Orlando.
I agree to the Safe Environment and Fingerprint policy.
(Required)
Yes
Have you taken the Safe Environment Training?
(Required)
Yes
No
Have you done the Fingerprint Background Check with the diocese?
(Required)
Yes
No
Number of NCYC conferences attended.
(Required)
0
1
2
3 or more
Emergency Contact
Name
(Required)
First
Last
Phone
(Required)
Consent
(Required)
I agree to the privacy policy.
Yes, I DO authorize the Faith Formation department of St. Catherine of Siena Parish, in Kissimmee, FL to take photos, videos or any type of recording to be used in the Parish Bulletin, Parish Website, or any other parish form. I waive from any claims, and release all the staff members, volunteers of St. Catherine of Siena Catholic Church in Kissimmee, FL, and/or the Diocese of Orlando, weather former, future, or current, from any and all claims, actions, cause of actions, suits, costs, expenses, liabilities, or/and damages.