The following form must be filled out by the parish or diocesan Child Safety Coordinator. Please list all chaperones and young adults that will be attending Generation Life with your parish or school and verify that they are in compliance with your home diocese safe environment requirements. This form must be submitted by January 13th, 2023. If any adults are added to your attendee list after the first submission, a second form must be filled out and submitted with the new additional names. Group Name* Group Leader Name* First Last Group Leader Email Parish, School, or Diocesan Child Safety Coordinator* First Last Parish, School, or Diocesan Child Safety Coordinator Email* Chaperones*Enter the name of each chaperone or young adult in your group, one per line. If you need to add more names to a list you have already submitted, only provide the new name(s) for this form submission.Child Safety Coordinator Affirmation* I affirm that this form is being filled out and signed by the above listed Child Safety Coordinator and I do have the authority to sign off on the safe environment compliance of the individuals listed above. Chaperones/Young Adults Compliance Affirmation* I affirm that each of the chaperones & young adults listed on this form is in compliance with our home (arch) diocesan safe environment requirements and youth ministry policies. CommentsThis field is for validation purposes and should be left unchanged. Δ
