Below are links to the 2019 Safe Environment Compliance Affidavit and General Release and Waiver Agreement. There are separate forms for delegations coming from the United States and Canada and one for those participating as individuals. The respective form should be completed by your diocese’s Safe Environment Program Coordinator and returned to NFCYM by November 1, 2019.

Why this form for Delegations? 

NFCYM is committed to providing a safe environment for participants. However, NFCYM does not know, select, screen, train, background check, or supervise the adults who chaperone youth participants at NCYC. These functions reside with delegation leaders and sending dioceses. For this reason, NFCYM requires a declaration from sending dioceses that the adults traveling with their delegations are cleared for service with minors.

When submitting the form to your diocesan safe environment program coordinator, it is good practice to include the list of adults attending NCYC as part of your delegation. If an adult must drop out, he/she may be replaced by another cleared adult without having to resubmit the form. You should, however, notify your diocesan safe environment program coordinator of the change.

Failure to fully execute the form and/or amending or striking through text will render your form null and void and your delegation will be barred from receiving NCYC credentials onsite.

For U.S. dioceses, this form was reviewed and affirmed by Catholic Mutual in 2013. The only changes are to the dates of the event.

Why this form for individuals?

Again, NFCYM is committed to providing a safe environment for participants. Speakers, artists, exhibitors, and volunteers are all required to meet safe environment standards, preferably of their home diocese*. Most often, safe environment compliance of these individuals is done in batches directly with the person’s home diocese. There are occasions when it is simpler for the individual to request verification of their compliance. For ease and standardization, a form has been created for individual use.

*If a person is not Catholic or cannot get cleared through his/her diocese due to timing, the Archdiocese of Indianapolis makes their safe environment program available. This includes both online training and a background check.

Returning Forms

Completed forms are due no later than November 1 and may be returned to NFCYM in one of the following ways:

  • Mail: NFCYM, ATTN: NCYC Safe Environment Affidavit, 415 Michigan Ave NE, Ste 40, Washington DC 20017

  • Fax: 202-526-7544

  • Email:

To verify your form has been received, please contact Michelle Orellana at or 202-636-3825 x10.

If you have any questions about the form, please contact Maureen Gross at 302-766-2221.