Youth Participation Agreement
The American Cancer Society Relay For Life requires one chaperone older than 25 for every five youth team members. For this event, a youth is considered anyone younger than 18. In addition to completing and turning in this agreement, the youth participant must also complete an event registration form (either online or a scannable form). Name Address City Home Phone ( ) Cell Phone ( ) Team Name Chaperone’s Name Chaperone’s Phone Number ( Birthdate State Email Team Captain’s Name ) Chaperone’s Cell Phone ( ) ZIP

In the event of an emergency, it might be necessary to reach a parent or guardian. Please print his or her name and phone number on the line below. ) Parent’s Name Parent’s Home Phone ( Parent’s Cell Phone ( ) Welcome to the American Cancer Society Relay For Life! We hope you’ll have a great time as you raise money and help fight cancer. The American Cancer Society goal is to provide a safe, fun, and positive experience for all Relay participants. As a youth participant, you play a valuable role in attaining this goal. Please read through this participation agreement.
While participating, Relay For Life participants shall: • Respect the individual rights, safety, and property of others • Avoid displays of overly affectionate behavior • Not participate in obscene and/or discriminatory language or roughhousing • Not be insubordinate to chaperones or the leader in charge of the event • Not possess or use weapons, alcoholic beverages, tobacco and/ or illegal drugs at any event, activity, or meeting, or remain in the presence of individuals who possess or use these items • Abide by all rules of the attended event, activity, or meeting • Participate in activities to the best of his or her ability • Notify a chaperone or staff person if he or she has concerns or medical needs during the Relay For Life • Not engage in conversations or activities that are sexual in nature • Not leave the event site(s) without permission from the chaperone, parent/guardian, and Event Chair • Pay any costs related to damage or destruction of property that he or she incurs, including any property damage to other Relay For Life participants or to third parties. Such costs will be charged to the youth participant and/or their parent(s) Disciplinary action Penalties and/or disciplinary action for infractions of this code of conduct may include any or all of the