Youth Works Leech Lake Reservation 2015
Kent UMC Youth Group Mission Trip Participant Application
Name:______
Parent Name/s:______
Current Grade:______School You Attend:______Age on 6/21/15:______
Address, city & zip:______
______
Phone Number/s: ( )______Church currently registered at:______
Cell Phone number: ( )______
Email address:______
Number of years at Mountain TOP*______T-Shirt size______
Will you receive service credit hours for participating in this trip? YES NO
*If you have a facebook account please add Rick Stout to your friends list if you haven’t already, and check your inbox for regular trip updates*
Youth Signature Needed Here:
I, ______, have earnestly and prayerfully considered serving in Lord at the Leech Lake Reservation next summer, and pledge my time and skills to this mission outreach.
I understand my participation in this mission trip includes participation at ALL the preparation meetings, and the Congregation Commissioning Service on June 21, 2015.I will notify the youth director Rick Stout as soon as possible if I will not be able to attend a mandatory meeting or related activity.
In addition to no illegal drug and alcohol use on this trip, I understand that this trip is a NON-SMOKING event. I will not use, buy, or possess any form of tobacco on this trip. Note: All youth and parents will be asked to sign an agreement to transport home. This required form will follow along with medical and release forms. I understand that my participation in this trip will not be considered until I have turned in a $100 non-refundable deposit and this application/covenant.
Youth Signature: ______Date: ______
Parent Section: Note: There will be hand-outs at most preparation meetings that will be used to update youth participants and parents about the trip. Although not necessary, parents are welcome at all preparation meetings. There will be one MANDATORY parent meeting June 21, 2015 prior to the trip.Health forms are DUE on that date.
Parent Signature Needed Here:
I believe my child has the health, maturity, and endurance to participate in this mission trip next summer. I will help facilitate his/her participation at all mandatory preparation meetings and related activities. I understand the $100 deposit is non-refundable with the exception of a family emergency. Furthermore, I understand that payments of $200, and $150 are due by February 22, and March 29, 2015 respectively.
I agree to the above statement and will abide by all its terms and will sign and turn in all forms required for this trip by the date requested.
Parent Signature: ______Date: ______
Applications are taken on a first come first serve basis, in order to reserve your spot, please return this form with your $100 deposit beginning September 21, 2014. Questions can be directed to Rick at 330-283-4838 or . The last day to join the trip is January 4, 2015. All applications/deposits received after January 4 will incur a late fee of $25.00, and will not be guaranteed a spot on the trip. Applications received after January 4will only be accepted at the discretion of the Youth Director and the Senior Pastor.