Please complete this Youth Pledge Form for the Tallahassee Leadership and Advocacy Trip.

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* 1. For my own safety and for the safety of others, I ______________________ acknowledge and agree to abide the following:


I understand that I am an ambassador of The Children’s Trust and my community, and will act accordingly at all times during this trip. 
I will respect the advisors’ and chaperones’ instructions at all times. 
I will be on time for all scheduled departures, meetings and events. 
I will not stray from the group nor be alone at any time while outside the hotel room.  
I will not enter the hotel room of another person/s without prior notification to my assigned chaperone.
 No drugs, alcohol or smoking at any point on this trip. 
I understand that the violation of any of the above means that I can be sent home at any point during the trip – at my parents’ expense.

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* 2. Date

Date

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* 3. Student Signature

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* 4. Date

Date

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* 5. Parent Initials of Acknowledgement 

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