2010 Ehko Ministry Trip Application

6th grade trip - Pittsburgh 7th grade trip - North Carolina 8th grade trip - Northeast Ohio
July 1-4, 2010 June 13-19, 2010 July 11-17, 2010
Total Cost: $150 Total Cost: $245 Total Cost: $175

Name:______________________ Birthdate (MM/DD/YY)___________Grade:_____ Male/Female

Address:________________________ City:______________Zip:_________ Phone:___________

E-Mail:_________________________ Parent Names:____________________ Campus: AC or GC

Student Information Form (the following should be completed on a separate paper, typed. It
should be at least one page, double-spaced, 12 point font):

1. Please tell us how you came to know Christ as your personal Lord and Savior, and how
you are currently growing in your relationship with Christ?
2. Tell about your involvement in various activities in and outside The Chapel and how they
have affected your life.
3. Why are you interested in going on a ministry trip? What talents or abilities do you
possess that would help contribute to the team and trip experience?

Parent Information Form (please complete on a separate paper, typed.)

Your child is applying to be a part of a summer ministry team/trip. Your thorough answers to the
following questions will help us in working with your son or daughter.

1. How do you feel about your child going on a ministry trip?

2. What are your child’s strengths and how can they contribute to a ministry team?
3. What can you tell us that will help in working with your child on a ministry trip?

REQUIREMENTS

• Student and parent must fill out and submit application by Sunday, March 28th. This form must
be sent to the youth office or given directly to an Ehko staff member.
• Student must pay a $50 non-refundable down payment by March 28th. This deposit is
included in the total cost for the each trip. (If this down payment is unable to be paid by this
time, please contact Eric Hays or Jarrod Williams for arrangements to be made.)
• Students must schedule an interview with an Ehko staff member on Sunday, April 11 (12 - 4 pm)
or Wednesdays, April 14, 21, 28 (4 - 6 pm). Interviews are 30 minutes each.
• Student must attend and participate in all team meetings as well as complete the requirements
designated for each meeting. (Student must call trip leader for excused absences.)
• Student and parent must attend the Mandatory, Parent-Student meeting for their trip, held during
June or July depending on which trip you sign up for.

There will be no exceptions! If you agree to and understand that you must fulfill each requirement in
order to go on the middle school ministry trip, then please sign here:
Student Signature: _______________________________________
Emergency Information

In case of an emergency dealing with my child, please contact the following:

1. Name ___________________________ Relationship _____________________

Home Phone ________________ Work ______________ Pager, Cellular _____________

2. Name ___________________________ Relationship _____________________

Home Phone ________________ Work ______________ Pager, Cellular _____________

3. Name ___________________________ Relationship _____________________

Home Phone ________________ Work ______________ Pager, Cellular _____________

Additional Information that might be helpful in an emergency:

In the following statements, The Chapel personnel refers to all authorized adult sponsors with the youth program,
both paid staff and volunteers.

I give permission for my student, named on this application, to attend and participate in The Chapel’s summer
ministry trip.
I give permission for The Chapel to photograph my child or myself and use those photographs for future
advertisement.
I give permission for The Chapel personnel to transport my student throughout the ministry trip.
I give permission for The Chapel personnel to make the necessary decisions in the event of a medical or dental
emergency involving my student.
I will not hold The Chapel or The Chapel personnel responsible for payment of emergency medical or dental
treatment involving my student.

Parent’s signature ______________________________ Date ____________

Insurance Company __________________________ Policy Number ____________________________
Allergies

Special needs/Additional information __________________________________________________________

Social Security # _________________________ (Will be used for emergency medical info only)