First Presbyterian Church, Hayward

Mexico Mission Trip 2015

April 4th – April 11th

Adult Packet

Checklist of things to turn in by

Sunday, March 8th, 2015

q $400.00 (Make checks payable to FPCH)

q Registration Form

q Medical Form

q Copy of Medical Insurance Card

q Waiver of Liability

q Integrity Agreement

q Covenant for Volunteer of Paid Workers with Children and Youth

q Prayer Page

q Copy of Passport

Questions about these registration requirements?

Call Paul Bagai at (510) 581-6203. ext.210

Registration Form

Mexico Mission Trip 2015

Name ______Date of Birth ______Sex ___

Address ______City ______Zip ______

Phone ______E-mail ______

Passport ID Number ______

Emergency Contact Information

Spouse or Other Family Member Name ______

Home Phone ______Alternate Phone ______

Release of Liability for First Presbyterian Church, Hayward

I recognize that participation in a trip of this nature may be hazardous or dangerous. Therefore, I release and discharge First Presbyterian Church of Hayward and all its officers, agents, servants, and employees, acting officially or otherwise, from any and all reason of injury, damage (including property damage to all of my belongings), loss, or death which may occur from any cause including, but not limited to, any accident and/or occurrence while participating individually or with others while on this Mission Trip.

Participant’s Signature ______Date ______

Participant’s Name (Printed) ______

Medical Form

Mexico Mission Trip 2015

Name ______

Doctor’s Name ______Phone ______

Medical Insurance Carrier ______Policy # ______

Please list any that apply:

§ Chronic illnesses or medical conditions ______

§ Medications currently taking ______

§ Operations or serious injuries (include dates) ______

§ Allergies to foods or medicines ______

§ Any activity restrictions ______

§ Any dietary restrictions (vegetarian, etc.) ______

§ Other medical conditions ______

§ Date of last Tetanus shot ______

Consent of Emergency Treatment

In case of emergency, I hereby give permission to the physician selected by the Mission Trip leaders to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for person named above as needed. I agree to bear the cost of any such necessary emergency treatment.

Adult Participant’s Signature ______Date ______

Name Printed ______

Baja Christian Ministries

“Behold, the Harvest is Ripe in Baja”

Waiver of Liability

THE UNDERSIGNED, desiring to participate in activities, programs and ministries promoted and/or facilitated by or through BAJA CHRISTIAN MINISTRIES, hereby agrees to assume any and all liability for the undersigned’s acts or missions in the course of the activity participated in by the undersigned, and further relieves BAJA CHRISTIAN MINISTRIES, its officers, Board of Directors, agents, and any and all other persons associated with or operating through BAJA CHRISTIAN MINISTRIES of and from any and all liability for injuries occurring in the Continental United States or outside of the Continental United States and agrees to indemnify and hold harmless BAJA CHRISTIAN MINISTRIES, its officers, Board of Directors and agents for any and all damages of injuries which may be caused by the undersigned in the course of participating in activities sponsored, promoted, or participating in by BAJA CHRISTIAN MINISTRIES.

The undersigned understands that these waivers and releases herein cover each and every member of the undersigned’s family and that the undersigned’s agreement in these waivers and releases is a precondition to the undersigned’s participation in activities sponsored, promoted, or participating in BAJA CHRISTIAN MINISTRIES.

Adult Participant: ______Date: ______

Signature: ______

Integrity Agreement

I, the undersigned, know and understand that it is ILLEGAL to bring into Mexico:

· Used clothing and shoes

· Any type of dried beans or rice

· Any live animals

· Frozen meats, fish or poultry for distribution in the communities

· Firearms and ammunition

· Gasoline in a gas can or other container

I promise that I will not bring any of these items into Mexico on my mission trip with Baja Christian Ministries. I understand that by doing so, it will jeopardize the border relationship with Baja Christian Ministries. I promise that I will not sneak them in my suitcase and give them away when I reach my destination, nor will I hide them in my vehicle.

If I am driving a vehicle, I promise that I will hold all persons in my vehicle accountable to this agreement. I promise that if I have some of these items in my vehicle that another person has unknowingly brought along, I will tell the BCM staff who is assisting our border crossing and promptly dispose of them before crossing the border.

Participant’s Name: ______

Participant’s Signature: ______

Church Group Name: First Presbyterian Church, Hayward

Date of trip: April 4th-April 11th, 2015

First Presbyterian Church of Hayward

COVENANT FOR VOLUNTEER OR PAID WORKERS WITH CHILDREN AND YOUTH

As a worker in the Ministries with Children and Youth of the First Presbyterian Church of Hayward (FPCH), I appreciate that it is a privilege to engage in this high and holy calling. I recognize with Daniel 12:3 that “Those who are wise will shine like the brightness of the heavens, and those who lead many to righteousness, like the stars for ever and ever.”

Depending on God, I humbly and earnestly pledge that I will help to provide ministry programs for children and youth, which teach the gospel of Jesus Christ. I will demonstrate the gospel through my Christian faith, integrity and conduct. I will hold myself to the following standards, which our church has adopted, believing them to be in accord with the Lord’s plan.

TO ENCOURAGE SPIRITUAL GROWTH (1 Thessalonians 5:8-11):

I will manifest a deep spiritual concern for the welfare of all children and youth.
My first desire shall be to bring about the salvation of each child or youth who does not know the Lord Jesus Christ, and to encourage the spiritual growth of those who do.

TO EQUIP WITH THE ARMOR OF GOD (Ephesians 6:13-18):

I will teach in accord with the doctrines of FPCH. I will set an example of personal prayer, Bible study, and regular worship, and I will model purity and modesty in dress, conversation and conduct. I will strive to seek holiness in my life as it will be a model for children and youth who come to know me (see Session’s Leadership Expectations).
I will use teaching materials that are biblically based. I understand that FPCH does not allow me to expose minors to any film or video game that exceeds a PG-rating (for age 12 and below) or a PG-13 rating (ages 13 through 17) nor to television, internet, music or other media productions which violate FPCH standards of peace, purity and wholesomeness, unless written parental permission is provided for viewing a specific film, video, broadcast or excerpt, the nature and purpose for that viewing having been described to parents in advance. When using any curriculum that deals with matters of human sexuality or reproduction, I will see that parents of regular participants are notified in advance. I will respect the wishes of parents who do not want their student to participate in that curriculum.

TO PROTECT THE MINISTRY (Proverbs 2:6-15):

1. I will comply with requests for verifications, references, records searches, test, fingerprints, or other background checks that may be required for my position.

2. I will complete a formal application process prior to acceptance, including reading and signing this document, I understand that should I refuse to comply with the application procedure, or have reason to answer “yes” below to the final question, or have a previous conviction record of any offense against children documented by our background check process, I will be excluded from participating in children’s and youth ministries (there will be no exceptions to this policy).

3. When meeting with students individually, I will meet in public places when it’s appropriate, helpful, safe and welcome to everyone involved. Nothing in this covenant document is intended to discourage important one-on-one ministry when it is appropriate, but rather to protect it, as well as to protect me, FPCH, and those to and with whom I minister.

4. Volunteers and staff should work in pairs and in group-settings whenever possible. Volunteers and staff should avoid one-on-one situations in most cases, unless meeting in a public place. It is recommended that children and youth be transported in groups, rather than alone.

5. I understand that in support of the church’s purpose and mission in ministry with youth and children is to introduce them to Jesus Christ and help them grow in their faith. I commit myself to persevere towards accomplishing that mission by….

· Praying for students earning the right to be heard

· Going where students are and building personal relationships with them

· Sharing my life (in age appropriate ways) and the Good News of Jesus Christ with students

· Inviting them to personally respond to this Good News, but loving them regardless of their response

· Nurturing students so they might grow in their love for Christ and the knowledge of God’s Word and become people who can share their faith with others through word and deed

· Helping young people develop the skills, assets and attitudes to reach their full God-given potential

· Encouraging students to live connected to the Body of Christ by modeling this myself, including regular and reverent participation in the worship services of the church

· Working with a team of like-minded individuals – volunteer leaders, committee members, parents and church staff

6. I will not allow my own reputation or that of the church to be hurt in any way as a result of my behavior with children or youth or other workers. Specifically, to avoid even any appearance of evil (in keeping with 1 Thessalonians 5:21-23), I will at all times avoid:

· Driving a vehicle in a manner that is illegal, unsafe or that otherwise sets a poor example for minors

· Having a child, youth or any fellow worker in any inappropriate embrace;

· Touching or talking to or gesturing to the minor or any fellow worker in a manner that is rough, coarse, overly-affectionate, suggestive or otherwise inappropriate.

7. I will give appropriate guidance to minors when needed to correct or prevent misbehavior. I will report serious or recurring misbehaviors by minors or adults to my supervisor or to a pastor.

8. I understand that FPCH does not permit the use of alcohol, tobacco, marijuana, illegal drugs or the consumption of similar harmful substances, nor the use of firearms or weapons, at any church functions on or off campus. Workers will not use these items or allow minors to use them at any church event. Violations are to be reported.

9. I understand that all FPCH sponsored outings must be recorded on the church calendar and that each minor must have written permission to participate from their parent or guardian in advance. Parents/guardians must be informed of the nature of the event, departure time, time of return, and mode of transportation. Other clearances may be needed for some special events, overnighters and trips.

10. If I am a volunteer worker, I understand that all activities I plan with FPCH children and youth must receive advance approval from my staff leader, whether the Director of Children’s Ministries or the Director of Student Ministries.

11. I will report violations of this covenant by any workers, paid or volunteer, to my supervisor, a pastor or to the Personnel Committee.

REPORTING OF MISCONDUCT and ABUSE

I understand that child abuse, neglect, and child sexual abuse are crimes in all states and must be reported to Church and Civil Authorities. If I learn of any alleged incident of abuse, neglect, or sexual abuse, misconduct or harassment (either the victim or a person witnessing it or who is told about it) I will immediately report it to the staff person supervising the activity and the Head of Staff Pastor.

In the case of alleged abuse by a member of FPCH, FPCH Staff member, Pastor, or anyone else in an FPCH leadership position against a minor connected with FPCH ministries: The Head of Staff Pastor shall convene a task force that includes an Elder of Children’s or Youth Ministries and the Elder for Personnel. The task force shall conduct an investigation of the reported incident or charge. Should the task force find the report or charge to be other than frivolous, the members shall advise Session, during an executive Session meeting, and take such other acts as are necessary to investigate and resolve the matter. All involved should hold information in strict confidence, subject to such disclosures as are required under FPCH procedures or are required by law. Further action will be taken in accordance with the PC(USA) Book of Order, the San Francisco Presbytery, and all legal requirements.

Note: The PC(USA) Book of Order defines sexual abuse as: “any offense involving sexual conduct in relation to (1) any person under the age of eighteen years or anyone over the age of eighteen years without the mental capacity to consent;

or (2) any person when the conduct includes force, threat, coercion, intimidation, or misuse of office or position. (D-10.0401c)

Have you ever been arrested, charged or convicted of any offenses involving children? _____ yes ______no

If you answered “yes”, please specify: ______

I have read this document and agree to these policies.

Signed: Date:

Mexico Mission Trip – 2015

Prayer Page:

For our March bulletin insert, please give us the following information. Everyone in worship that morning will receive 2 or 3 Mexico Mission trip participants to pray for!

Name ______

Occupation ______

How many Mexico trips have you attended including this one? ______

Why did you sign up for the trip? ______

What are you most looking forward to?

What do you think will be the biggest challenge for you? For what would you like prayer?

Please complete and return at our March 8th meeting. Questions? Talk to Paul!