World Youth Day 2016 Pilgrim Eligibility Forms Catholic Archdiocese of Sydney
Welcome Thousands of Australians have travelled to World Youth Day and hold wonderful memories. They ve experienced conversion to Christ or a deepening of their existing faith and ideals. Last World Youth Day in Rio Pope Francis joined millions of young people who answered the invitation to be witnesses of faith. We now look forward to a unique World Youth Day in Krakow, Poland, the home of St John Paul II, the father of World Youth Days. Poland is a deeply cultural and spiritual land, rich in history. The places we visit will invite us into the theme of mercy, expressing God s love for humanity. I m looking forward to leading school students and young adults from our Archdiocese on this once in a lifetime journey of faith. Come and join us for World Youth Day in Poland in 2016! Most Rev Anthony Fisher OP Archbishop of Sydney 2
About WYD 2016 World Youth Day 2016 (WYD2016) will be held in Krakow, Poland from 26-31 July, 2016. The Catholic Archdiocese of Sydney (Archdiocese) is offering young people (Pilgrims) aged 18-35 an opportunity to attend WYD2016 (Pilgrimage) through a number of tours being offered by Cosmos Tours which has been named by the Australian Catholic Bishops Conference as the Official Tour Operator for Australia and New Zealand for WYD2016. There are four possible tours (Tour) Pilgrims can choose from as follows: Holy Land Pilgrimage Footsteps of JPII Pilgrimage Marian Shrines Pilgrimage WYD Direct Pilgrimage All details of the above tours, including; prices, maps, itineraries, inclusions and recommendations regarding insurance can be found at https://travelinsurance.agaassistance.com.au. Cosmos WYD Tours will be responsible for all travel, accommodation and logistics associated with the pilgrimage. All tour costs will be paid by pilgrims directly to Cosmos and not to the Archdiocese. The Archdiocese will provide group leaders, along with chaplains and staff, who will attend each pilgrimage with the pilgrims. All pilgrims must agree to the Cosmos Booking Terms and Conditions (available online at www.wyd2016.com at the time of booking) and to the matters contained in this Application Pack (including the Pilgrim Code of Conduct and the matters set out under Authorisation ) in order to participate in the Pilgrimage. 3
Welcome to World Youth Day 2016! Thank you for registering with the Catholic Archdiocese of Sydney to attend World Youth Day 2016 in Krakow, Poland! We are excited that you have decided to join with us as we journey together on this exciting pilgrimage. The next stage of registration is to complete the eligibility forms as a requirement of registration. Please complete these forms honestly and thoughtfully and follow the steps below. Step 1: Complete the following forms (type directly onto the PDF or print & complete by hand): General Information Pilgrim Reflection Questions Pilgrim Code of Conduct Pilgrim Referee Form Confidential Medical Report General Authorisation Step 2: Send the completed forms via email or post to: wyd@catholicyouthservices.org World Youth Day C/o Catholic Youth Services 108 The Crescent Homebush West NSW 2140 Step 3: You will be notified within 2-3 weeks from receipt of your application whether you will be able to participate in the pilgrimage. You will then receive instructions to complete your online registration and submit the $500 deposit required to secure your place on the Sydney pilgrimages. WYD16 will be an amazing experience for you! If you have any questions, please don t hesitate to contact Monica Bautista (World Youth Day Project Officer) on (02) 9764 4357 or via wyd@catholicyouthservices.org. 4
To be completed by the pilgrim: PILGRIM APPLICATION FORM TITLE FIRST NAME (as on passport) SURNAME (as on passport) PREFERRED NAME RESIDENTIAL ADDRESS EMAIL MOBILE PHONE NUMBER HOME PHONE NUMBER DATE OF BIRTH AGE NATIONALITY (as on passport) WHAT ARCH/DIOCESE DO YOU RESIDE IN? WHAT PARISH / GROUP / MOVEMENT DO YOU MOST CLOSELY IDENTIFY WITH, IF ANY? Are you planning on joining the Sydney pilgrimage as an individual or as part of a parish/ group/ movement? If it is as part of a group, please indicate the name of your parish/group/movement. Do you hope to make extra travel arrangements and/or travel adjustments either before or after the pilgrimage? YES / NO Note: Full details will be required when booking through Cosmos our travel provider, but please outline briefly here what the plans are: Tick your preferred pilgrimage option. Note: Full itineraries at www.catholicyouthservices.org/wyd. Holy Land + WYD + Retreat (3 weeks) Footsteps of JPII (Rome & Poland) + WYD + Retreat (3 weeks) Marian Shrines (Lourdes & Fatima) + WYD + Retreat (3 weeks) WYD Direct + Retreat (2 weeks) 5
PILGRIM REFLECTION QUESTIONS 1. Tell us a little bit about yourself: family, hobbies, interests, study, work etc. 2. What is your current involvement in your parish/group/movement, if any? 3. What has motivated you to be a part of the Sydney WYD pilgrimages? 4. WYD is an intense, physical, emotional and spiritual experience. It cannot be equated with a holiday. Do you think you will be able to handle this intensity and what similar experiences have you had before? 6
5. The entire WYD experience will be surrounded by people, e.g. transport, accommodation, events etc. How well do you deal with being surrounded by many people and travelling in large groups? 6. What other challenges do you think you might face on WYD? 7. What gifts and talents would you bring to your fellow pilgrims at WYD? (It is required that the leader of the group submit a sheet with the group name, pilgrimage option and list of all members of group to help us coordinate small groups. This can be done by attaching a document with the list.) Name: Signature: Date: 7
PILGRIM CODE OF CONDUCT The Pilgrim Code of Conduct has been developed to ensure positive and respectful interaction in the Sydney World Youth Day pilgrimages. Pilgrim conduct should be characterised by common sense, politeness and cooperation. Pilgrims should be mindful that they are ambassadors for the Catholic Church as well as their family, community and country. Pilgrims must read, sign and abide by the following Code of Conduct: I will prepare for the Sydney WYD pilgrimages by participating in the pre pilgrimages formation program. I understand that at all times I must ensure the safety and comfort myself, other pilgrims and leaders and I will let my leader know if I have any concerns or issues. I will abide by the laws of countries visited, and show respect towards local practices and customs. I will dress in a way that is appropriate, modest and shows respect to my fellow pilgrims. I will actively and positively engage in the activities of my pilgrimage program. I will accept and follow the reasonable expectations of pilgrimage leaders at all times I understand I am personally responsible for my own purchases, passport, money, property, personal health and hygiene. I will advise my small group leader if I intend to depart from the activities of my group. I will consume alcohol in moderation and only at times that do not impact upon the overall WYD pilgrimage. I will not supply alcohol or any controlled substance to a minor. I will notify a member of the leadership team about any witnessed or suspected inappropriate behaviour shown towards another pilgrim. I will try to resolve any issues or disputes with fellow pilgrims amicably and fairly. The following will NOT be permitted by any pilgrim during the Sydney WYD Pilgrimages: Dangerous, demeaning or threatening behaviour (including bullying and harassment). Inappropriate sexual conduct; including harassment and behaviour that goes against the Christian vision for chastity and genuine human love. Involvement with illegal substances in any way. Dissemination of any embarrassing, degrading or humiliating images, video, or written communication. Damage to any property or personal belongings. I have read the above Code of Conduct and I agree to follow it. I understand that if the Code is seriously breached, I may be asked to leave the Sydney WYD Pilgrimages. I understand that ALL associated costs to return to Australia, will be at my own expense. Name: Signature: Date: 8
PILGRIM REFEREE FORM World Youth Day is an international celebration of young people and faith. In assisting with their preparations, each pilgrim is asked to nominate a referee who is able to pastorally support them before and after their pilgrimage experience. Your referee should be someone who knows you and where possible, someone connected to your parish/group/movement. This person cannot be related to you. Referee s Role: This pilgrim referee form is a necessary part of the pilgrim application process. You may wish to complete it in the presence of the person who has nominated you or complete the form confidentially and if so, you may return it directly to Catholic Youth Services. You may also be contacted by organisers of the Sydney World Youth Day Committee to discuss your responses further for the benefit of the potential pilgrim. If you have any questions about completing this form or would like to discuss it further, please contact us at the details below. wyd@catholicyouthservices.org (02) 9764 4357 World Youth Day C/o Catholic Youth Services 108 The Crescent Homebush West NSW 2140 NAME OF PILGRIM: PILGRIMAGE OPTION: 1. Do you think the young person understands that this is a pilgrimage (not a holiday) and as such it is a journey into their spirituality and faith life? Please tick one box. YES NOT SURE NO 2. To what extent is this person involved in their parish/group/movement and how do you see them being involved in the future? 9
3. Are you aware of any reasons, including medical that may impact upon this person s ability to participate fully in the pilgrimage to World Youth Day 2016? If so, what are they? 4. Do you believe this person will be able to handle an experience of this intensity (including the physical demands that may be placed upon them)? 5. World Youth Day attracts a large number of people and the Sydney WYD Pilgrimages will be experienced as a large group. How well does this person manage being in a group? Name of Referee: Contact Number: Address: Referee Signature: Date: 10
CONFIDENTIAL MEDICAL REPORT The information collected in this medical report is requested in order to provide an adequate response to pilgrims and to assist in case of illness or accident. This information must be completed with the utmost accuracy. Information will be held in confidence by the Pilgrimage Coordinator and/or Group Leaders and only made available to medical personnel and other appropriate people in the case of emergency. Further medical information will be requested when completing registration with the tour operator Cosmos. 1. I understand that every effort will be made by the leader to confer with me and my nominated contact person in the event that I suffer any illness or accident. 2. I hereby authorise a representative of the Archdiocese to provide consent on my behalf where it is impracticable to communicate with me or my nominated contact person, to my receiving such emergency medical or surgical treatment as may be deemed necessary at any time during the Pilgrimage. 3. I agree to indemnify the Archdiocese, its employees, volunteers, agents, officers and contractors in relation to all costs, expenses, claims or liability arising out any medical or dental assistance given to me. GIVEN NAME: SURNAME: PILGRIMAGE: DOB: Please answer the following questions: Are you under regular medical treatment from a doctor? YES / NO If YES, please give details of the condition and treatment Please indicate any special needs /illnesses/disabilities that the participant experiences of which the Archdiocese should be aware (e.g. asthma, physical disability) 11
Does the participant suffer from any mental illness (e.g. depression, anxiety, panic attacks etc )? If YES, please give details of the condition and treatment. Further documentation may need to be provided Does the participant need to take any medication for a medical condition? YES / NO If so, what is the name, dosage, strength and frequency of the medication Name and Phone number of family doctor: To the best of my knowledge, all information provided in this medical report is complete and correct. Name: Signature: Date: It is recommended that Pilgrims with health concerns see their doctor before departing overseas. The information collected in this report will be destroyed 6 weeks after the Pilgrimage. Should you want access to this information please contact Monica Bautista (Project Officer). 12
GENERAL AUTHORISATION 1. I, the undersigned, apply to participate in the Sydney WYD Pilgrimages in July and August of 2016. 2. I understand the nature of the activities during the pilgrimage may include, but are not limited to indoor and outdoor group activities, basic accommodation, communal eating, socialising, travelling in private cars, chartered buses and trains, and that risks may arise during these activities. 3. I understand that during the Pilgrimage activities may involve physical demands (i.e. mission work that may include, but is not limited to heavy lifting, transporting of goods, painting, building and construction and that is my responsibility to choose the appropriate pilgrimage to suit my own physical and emotional health. 4. I indemnify and release the Archdiocese, its officers, employees, volunteers and agents against claims and losses of any kind arising out of or in connection with my participation in the Pilgrimage. I accept responsibility for payment of all expenses associated with any such claims or losses, including, but not limited to, responsibility for payment of medical expenses incurred by myself. 5. I agree to abide by the Pilgrim Code of Behaviour set out above, the terms of this Authorisation and any rules notified to me by the Archdiocese (collectively, Rules ) from time-to-time and to participate in all aspects of the pilgrimage. I understand that a breach of these rules may result in the removal of myself from the pilgrimage. If I am removed from the pilgrimage, I accept responsibility for all costs incurred, including any travel costs associated with my early return to Australia. 6. I agree to comply with all relevant legislation during the pilgrimage. 7. I consent to the Archdiocese filming and/or photographing me (Footage). 8. I consent to the Archdiocese and its nominees using my name, image and likeness and that this footage may be used by the Archdiocese for promotional, marketing or other purposes associated with the pilgrimage. 9. I consent to the Archdiocese or its nominees without limitation using, reproducing, exhibiting, editing, adapting, compiling with other works or materials, transmitting, broadcasting, publishing and distributing the footage in any media at its discretion. 10. I acknowledge that the Archdiocese is not obliged to publish or otherwise use the footage or any part of it. 11. I agree that any form of intellectual property rights in the Footage (audio and visual) and all works derived or created under it vest in the Trustees of the Roman Catholic Church for the Archdiocese of Sydney (Trustees) and that to the extent that any such intellectual property rights vest in me, I assign these rights to the Trustees. I consent to any act or omission by the Trustees and the Catholic Archdiocese of Sydney which may otherwise infringe my moral rights. 12. To the full extent permitted by law, I consent to the doing of anything in relation to the footage that (but for the consents provided in this letter) would otherwise infringe any moral rights, performers rights or similar non-assignable personal rights that I might otherwise have including but not limited to publishing footage without attribution and modifying/adapting the footage. 13. I agree to execute all documents and do all things required by the Archdiocese for the purpose of giving effect to the above requirements. 14. I understand that the Archdiocese requires I take out an appropriate personal travel/accident insurance policy for the duration of my journey and that it is my responsibility to take out such insurance. 15. I understand that it is my responsibility to obtain medical confirmation that I am able to participate (including appropriate vaccinations) before I undertake the pilgrimage. 13
16. I acknowledge that the Archdiocese collects my personal information to promote the pilgrimage. The Archdiocese may disclose this personal information to its nominees which it engages to promote the Pilgrimage. The Archdiocese is bound by the National Privacy Principles in the Privacy Act 1988. I can access, modify, or delete the personal information the Archdiocese holds about me by contacting Monica Bautista (Project Officer) at the contact details set out above. A copy of the Privacy Policy can be found at https://www.sydneycatholic.org/others/privacy.shtml. 17. I agree that the laws of New South Wales, Australia govern this letter. FULL NAME SIGNED DATE 14