Adult Participant Registration/Verification - Diocesan Form
Vocations Picnic, Thursday, July 20, 2023: 4:00pm - 8:00pm, Christ the King Retreat House, Syracuse
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Participant Information
Adult participants are individuals over the age of 18 and over and who are attending the Vocations Picnic as a participant. Participants may not assume any responsibility for minors at any time per the Diocesan Child and Youth Protection Policy.  If you have any questions, please contact the Office of Safe Environment at 315.470.1421 or safeenvironment@syrdio.org.
First Name *
Middle Initial
Last Name *
Other last name(s) used
If applicable
Gender *
Date of Birth *
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Last four digits of Social Security Number *
Address *
City *
State *
Zip *
Primary phone number *
Email address *
Parish/School *
Specific Food Allergies *
Verification and Signature
I understand that as an Adult Participant with the Diocese of Syracuse, I will not assume responsibility for any minor or be alone at any time with a minor during the event.    

I hereby give my consent to the Diocese of Syracuse, the Office of Vocation Promotion, and participating parishes to photograph, film, videotape and then use, reproduce, and publish said images of me / us for the purpose of event advertisement and promotion.
I have read the above and agree *
Electronic Signature *
In place of your signature, please type your full legal name.
Date *
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