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Dear parent and/or guardian: This is the First United Methodist Church registration packet for the Senior

High Mission Trip to the Cass Lake Reservation in Minnesota on June 9-14, 2013. We will be partnering with the national youth missions organization, YouthWorks! for our trip to maximize the mission experience for our youth. For more information on this organization, please feel free to visit www.youthworks.com. The cost of this trip is $350 which includes all expenses aside from souvenirs. While each youth is expected to cover the cost of his/her trip, the youth will have opportunities for fundraising to offset a portion of the cost. Financial aid is also available. Please use this sheet as a guide to fill out the forms enclosed. It is important to note that all participants including FUMC youth, friends, and adult leaders must complete this packet before their registration is considered to be complete. 1. Mission Trip 2013 Registration Form [neon yellow sheet] *all participants including adult leaders must fill out this registration form 2. Permission and Release Form [back side of neon yellow sheet] *youth will participate in the Cass Lake Mission Trip on June 9-14, 2013 3. Transportation and Medical Release Consent Form [pink sheet] *youth will participate in the Cass Lake Mission Trip on June 9-14, 2013 *be sure to list ANY current medications, allergies, and/or medical conditions on this sheet *attach photocopy of BOTH SIDES of the health insurance card 4. Youth Covenant Form (Adult Covenant Form for adult leaders) [cream sheet] *please read through this sheet with your youth to ensure their understanding *youth will participate in the Cass Lake Mission Trip on June 9-14, 2013 *have the YOUTH sign this sheet as well as yourself 5. Tentative Travel Itinerary [white sheet] *please note that this is TENTATIVE; as times become concrete and the schedule becomes solidified, you will receive an updated itinerary 6. Mandatory Mission Meeting [white sheet] *please note the word MANDATORY in this memo *both the youth participating as well as a parent/legal guardian must be present Complete forms 1-4 and make a photocopy of each. Return the set of original forms along with the copy of your health insurance card and the $150 non-refundable deposit to the main office at First United Methodist Church by 6pm on Sunday, April 14, 2013. Please keep all white sheets provided in this packet for your own future reference. If you have any questions, comments, or concerns, please feel free to contact me via email or phone. Peace in Him,

Lynsey Rittenbach
youth@firstumcfargo.org 701.232.4416

first united methodist church

senior high youth group

cass lake mission trip 2013


registration form Date: _____________

Youth Information
Name: _________________________ Birthday: _________________________ Gender: M or F Grade & School: _________________________ Youth Cell #: _________________________ Receive Texts: Y or N Home Phone #: _________________________ Home Address: _________________________ _________________________ Youth email: _________________________ T-Shirt Size: _________________________

Parent/Guardian Information
Parent Name: _________________________ Cell #: _________________________ Home Phone #: _________________________ Home Address: _________________________ _________________________ Parent Name: _________________________ Cell #: _________________________ Home Phone #: _________________________ Home Address: _________________________ _________________________

Medical Information
Do you have any allergies and/or other medical conditions we should be aware of in order to make special arrangements during any part of this trip? If so, please list: _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________ _________________________

** This registration form is due along with the appropriate fee by April 14, 2013**
First United Methodist Church * 906 1st Ave. S. Fargo, ND 58103 * 701.232.4416

first united methodist church

senior high youth group


permission and release form
I want my child to participate in First United Methodist Church sponsored activities and events. I give my permission and consent for _____________________________________________(name of youth) to participate in _______________________________________ (activity/event) sponsored by First United Methodist Church in Fargo, ND and its ministry partners on _____________________(date of activity/event) subject only to any specific limitations noted below.* I, on behalf of my child, release, hold harmless, covenant not to sue, and forever discharge to the fullest extent permitted by law, First United Methodist Church and its related or connectional organizations, its agents, employees, officers, directors, affiliates, successors, assigns, and all others of and from any and all claims, demands, expenses, personal injury, wrongful death, causes of action, lawsuits, damages, and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I or my child ever had or may have, arising from or in any way related to my childs participation in the activities conducted by, on the premises of, or for the benefit of the church. It is known that while participating in First United Methodist Church Youth Program events, my child may be photographed or videotaped for promotional materials for First United Methodist Church and its partners; including but not limited to print and social media such as brochures, pamphlets, websites, facebook, Twitter, Instagram, and videos. I have had an opportunity to ask questions. Any questions I have asked have been answered to my complete satisfaction. I subjectively understand the risks of my childs participation in the above activity, and knowing and appreciating these risks, I voluntarily choose to allow my child to participate, assuming all risks of injury or even death due to my childs participation. The provision of this Permission and Release will continue in full force and effect even after the termination of the activity conducted by, on the premises of, or for the benefit of, the church, whether by agreement, by operation of law, or otherwise. This Permission and Release is governed by the laws of the State of North Dakota and is intended to be as broad and inclusive as is permitted by that law. If any provision of this is held invalid or unenforceable by a court of competent jurisdiction, the remaining provisions will continue to be fully effective. This Permission and Release contains the entire agreement between the parties. In the event I cannot be reached, I authorize and direct any adult leader representing the church to make emergency medical decisions for my child and have completed and attached the Medical Release and Transportation Consent Form.** I have read and understand the Youth Covenant that my child has signed for activities and if he/she does not abide by this Covenant or by the rules set by adult leaders, I may receive a call and may be responsible for the alternate transportation of my youth home early and the costs thereof.*** *Prohibited activities: As a result of medical conditions or for other reason, I do not want my child to engage in any of the following listed activities (describe with specificity).

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________


I am the parent and/or guardian of the above named child, and am of lawful age and legally competent to sign this Permission and Release. I understand the terms of this Permission and Release and I have willingly signed it as my own free act. Signature: __________________________________________ Date: ________________________________________
Printed Name: _____________________________________ Relationship to youth: _____________________________________

** A separate Medical Release and Transportation Form is referred to and should be completed and attached to this sheet. *** A separate Youth Covenant form is referred to and should be completed and attached to this sheet.

first united methodist church

senior high youth group


transportation and medical release form
As a parent and/or guardian, I give ____________________________________ (name of youth) permission to be transported by First United Methodist Church and its Youth Programs as a part of his/her participation in ____________________________________(activity) on _________________________(date of activity), by whatever means of transportation the church and Youth Programs deem appropriate. As a parent and/or guardian, I hereby authorize the above named youth to be given the necessary treatment by a qualified and licensed medical doctor in the event of a medical or dental emergency which, in the opinion of the attending physician, may endanger his or her life, or cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me via the emergency contact information provided on the bottom of this sheet. My child is currently taking the following medications and/or subject to the following allergies and/or medical conditions, and I authorize the church to disclose such allergies or medical conditions to a licensed medical doctor/professional in the event my child should require emergency medical or dental care (please describe allergies or medical conditions with specificity on the lines provided). Current Medications: ________________________________________________________________________________ _________________________________________________________________________________________________ Allergies/Medical Conditions:_________________________________________________________________________ _________________________________________________________________________________________________ Childs full name: __________________________________________ Date of Birth: ____________________________ Family physician: ____________________________________________ Phone: ________________________________ Health insurance company: ____________________________________ Phone: ________________________________ Health insurance address: ___________________________________________________________________________ Health insurance policy/group number: ________________________________________________________________ Name of policy holder: _______________________________________ Phone: ________________________________ In case of emergency, contact: Name: ________________________________________ Relationship: _______________________________________ Address: ______________________________________ Home Phone: _______________________________________ ______________________________________ Cell Phone: ________________________________________ If unable to contact above named in case of emergency, please contact: Name: ________________________________________ Relationship: _______________________________________ Address: ______________________________________ Home Phone: _______________________________________ ______________________________________ Cell Phone: _________________________________________
I am the parent and/or guardian of the above named child, and am of lawful age and legally competent to sign this Transportation and Medical Release. I understand the terms of this Transportation and Medical Release and I have willingly signed it as my own free act with the purpose of authorizing necessary transportation and disclosing medical information and authorizing medical treatment under emergency circumstances in my absence as the parent and/or guardian.

Signature: __________________________________________ Date: ________________________________________ Printed Name: _____________________________________ Relationship to youth: ____________________________
**Attach copy of Health Insurance card**

first united methodist church

senior high youth group


youth covenant form

As a youth within this Christian community working together in the spirit of grace and love for one another, I agree to enter into this Covenant with First United Methodist Church and its youth programs for ____________________________________(activity) on _________________________(date of activity). This covenant outlines the policies and goals that have been established to be our guide during our willing participation in activities offered through First United Methodist Church. I covenant to abide by the rules set and stated by the adult leaders of each activity as well as respect the adult leaders, trusting they have my safety in mind at all times. I covenant to treat others as I would want to be treated, with equal respect to them and their property, regardless of our differences. I covenant to use my best judgment at all times, knowing that the adult leaders are always willing to give advice if I need it. I covenant to not bring along, purchase, partake of, or partake in any activities involving alcohol, illegal drugs, tobacco, cigarettes or weapons while participating in each activity. I covenant to keep my thoughts, speech, and behavior in line with that which is appropriate for a disciple of Jesus Christ. I covenant to speak when something must be said, but also to communicate in a mature and kind manner, listening and discussing issues that may arise with patience and integrity as well as a positive attitude. I covenant to be a good representative of First United Methodist Church and its youth programs, remembering that I should first and foremost represent Christ in all that I do and say. I covenant to have fun and rejoice in the relationship of my fellow brothers and sisters in Christ as we experience our world, our humanity, and our God in new ways.

I have read this covenant form fully and know that if I fail to abide by any of these rules or guidelines and thus break this covenant, my parent and/or guardian may be called and I may be sent home early.
Signature: __________________________________________ Date: _________________________________ Printed Name: ____________________________________

I am the parent and/or guardian of the above signed youth and have witnessed the signing of this covenant. I have also read this covenant fully and know that if my child fails to uphold this covenant, I will be called and may have to arrange for my child to travel home early.
Signature: __________________________________________ Date: _________________________________ Printed Name: ____________________________________ Relationship: _____________________________

first united methodist church

senior high youth group

cass lake mission trip 2013


travel itinerary Sunday June 9, 2013 1:00 pm 1:15 pm 4:30 pm Meet at FUMC downtown to load bus Depart from FUMC downtown Arrive at YouthWorks! Site in Cass Lake, MN

Begin YouthWorks schedule. 6:30 pm Supper 7:00 pm Youth orientation meeting 8:00 pm CLUB 9:30 pm Church group time 11:15 pm Lights out Monday-Thursday [YouthWorks typical daily schedule] 7:00 am Wake up 7:15 am Breakfast/ make lunch 8:15 am Quiet time/personal devotions 8:45 am Group prayer/site send off 9:00 am Depart for work sites Noon Lunch at work site 3:30 pm Clean up/leave work sits 4:00 pm Shower time/free time 5:30 pm Dinner and cleanup 6:30 pm Group evening activity 8:45 pm CLUB 9:45 pm Church group time 10:30 pm Free time/ get ready for bed 11:15 pm Lights out
Friday June 14, 2013

6:30 am Wake up 6:45 am Site cleanup/pack vehicles/pack breakfast 8:30 am Week evaluations/free T-shirt/group picture/good byes End YouthWorks Schedule
9:00 am 12:00 pm Depart from Cass Lake, MN Arrive at FUMC downtown, clean bus, and say goodbyes

first united methodist church

senior high youth group


mandatory mission meeting memo Who: What: Mission trip participants, parents, FUMC pastors and youth staff Mandatory mission meeting! After grilling supper and starting a bonfire, we will fill out final YouthWorks paperwork, receive information packets for the trip, discuss the art of packing, collaborate on packing list items, tie-dye trip T-shirts, and answer any last minute questions prior to our departure on June 9. Monday, June 3, 2013 6:00pm Lynseys House (3301 - 1st St. N Fargo) A beverage for you to drink and a lawn chair or blanket for you to sit on

Date: Time: Place: Bring:

If you get lost or have any questions, call Lynseys cell: 701-866-9382