June 25-July 1, 2017

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1 2017 SR. HIGH MISSION TRIP Nashville, TN June 25-July 1, 2017 St. Paul is organizing this mission trip through Group Mission Trips. Group Mission Trips has been providing mission opportunities for 30+ years. Nearly 300,000 youth and adults have served people in need through Group Mission Trips. When you join the Nashville Week of Hope team...you'll have the chance to minister to the least of these that Jesus described in Matthew 25. They are the homeless and hungry living on the streets, the senior citizens in need of help with home care, the children who need help learning to read, the members of a small inner-city church who want to make a difference in their community but don't have the resources to do it on their own. Pre-Early-Bird Registration $375 ~ Complete pages 2-5 of this application ~ Attach $100 non-refundable deposit ~ Turn in or mail (postmarked by Sept. 11) application & deposit* by Sept. 11, 2016 Cost: Early-Bird Registration $450 ~ Complete pages 2-5 of this application ~ Attach $100 non-refundable deposit ~ Turn in or mail (postmarked by Nov. 13) application & deposit* by Nov. 13, 2016 * deposit will not be cashed until application is accepted We have a limited number of registrations (30 slots) Regular Registration $525 ~ Complete pages 2-5 of this application ~ Attach $100 non-refundable deposit ~ Turn in or mail (postmarked by Jan. 8) application & deposit* by Jan. 8, 2017 Questions? Want scholarship information? Contact Or *scholarship applications available only through early bird registrations -1-

2 2017 SR. HIGH MISSION TRIP Nashville, TN June 25-July 1, 2017 Please print legibly all fields are required: Today's Date: T-Shirt Size: S M L XL Student's Full Legal Name: First Middle Last Address: City: State: Zip: Student's Date of Birth: Parents Name(s): Contact Phone: Completed Grade In June 2017 Current School: Parent's Contact All future correspondence (acceptance information, release forms, updates, etc.) will be ed to this address we will not be mailing out information packets. To be completed by student: 1.) Why do you desire to go on this mission trip this summer? 2.) What personal goals do you hope to accomplish by participating in this trip? Please turn completed application into the church with $100 non-refundable deposit by Sept. 11, 2016 for Pre-Early Bird, Nov. 13, 2016 for Early Bird, or Jan. 8, 2017 for Regular Rate. Half of your remaining balance is due by March 12. Your full balance is due in full by May 14. Questions? Contact Dave at

3 Pre-Trip Meeting Attendance Understanding Recent youth ministry research has shown that single, mountaintop experience trips have little impact on the lives of the participants. Mission trips should be an extension of the love of Christ we know in our own lives and an opportunity to share that love with those we minister to while on Mission trips. In order to better prepare for a mission trip, there will be several pre-trip youth meetings. These opportunities will help prepare youth for a more meaningful trip experience. The minimum requirements listed below are simply a starting point toward the goal of developing regular and faithful participation in Bible study and worship. I understand that part of going on a mission trip is preparation for the experience. Part of this preparation is committing to study of God's Word, prayer, faithful worship, and attendance at necessary pre-trip events. By signing below, I will make my best effort to attend all pre-trip meetings. If I will be absent from any, I will communicate my upcoming absence to the Director of Family & Youth Ministry at least two weeks prior to the affected date. I may be asked to make up missed material if deemed necessary by the Director of Family & Youth Ministry. If I am currently a member of St. Paul Lutheran Church & School, I understand that I am expected to maintain 75% worship attendance and 75% Sunday morning Bible study attendance to remain eligible for trip participation. The dates of the required pre-trip meetings are as follows: 1/22/2017 2/12/2017 3/12/2017 4/9/2017 5/14/2017 6/18/2017 I understand and agree to the information as presented above PARTICIPANTS NAME LEGAL GUARDIAN / / DATE *Parent attendance required at this meeting -3-

4 Financial Memo of Understanding 1. I understand that I am responsible for paying 100% of the funds, required for the trip. The money I raise covers travel costs, lodging, most meals, and programming elements. I am responsible for any souvenirs, food/drink while traveling to and from the trip destination, and personal items. 2. Any payment made more than 10 days after the due date will incur a $20 late fee. Half of your remaining balance is due by March 12. Your full balance is due in full by May Financial donations made to St. Paul Lutheran Church & School are not mine they belong to God and have been given to St. Paul in order to accomplish the mission and work of the church. This policy is also in place to comply with IRS codes. 4. If, for some reason, I do not ultimately participate in the mission trip to which I have been accepted, I am responsible for any fees incurred as a result of my cancellation. 5. If I do not raise enough money to pay for my trip, I may not be able to go. Any money raised will be applied to the current trip or materials needed. 6. If I raise an amount of money that exceeds my needs, remaining money will be dispersed to other team members in need or used by the youth ministry program for other financial needs. 7. If, for some reason, I do not participate in the mission trip to which I have been accepted, I understand that the monies donated to my trip cannot be refunded to me or to the donors. All materials that have been purchased with donated funds cannot be transferred outside of the trip. 8. In order to comply with the IRS, all checks for support of my trip must be made out to St. Paul Lutheran Church. 9. If inappropriate behavior and/or the breaking of any covenant polices causes me to be sent home early from the mission trip as a disciplinary action, none of the money raised will be refunded to me or any donors. 10. If I am sent home for inappropriate behavior and/or breaking of any covenant policies, it will be at my parent's and/or legal guardian's expense I have read the above and agree to the above policies, rules, and terms. PARTICIPANTS NAME LEGAL GUARDIAN / / DATE -4-

5 Parental Permission, Authorization, Release and Waiver Form St. Paul Lutheran Church and School, Detroit Rd., Westlake, OH Youth s Name: Birth Date / / Last First M.I. Youth's Cell Phone: Grade Member or Guest? Circle One Youth Parent Address: Parent/Guardian 1: Home Phone: Work Phone:_ Cell Phone: Parent/Guardian 2: Home Phone: Work Phone:_ Cell Phone: Emergency Contact:_ Phone: Relation to Youth: Medical Insurance Carrier: Policy #: Doctor s Name:_ Phone: *Please also attach copy of your health insurance card Medical Information: (Allergies/Medications, etc.) Please signify your consent by checking the box below. I grant the representatives and employees of St. Paul Lutheran Church and School in Westlake, OH, to photograph and/or film my child and understand that his/her image may be used in video presentations, printed publications, Facebook, or on St. Paul s website. I understand my child has been invited to attend Youth Ministry events and activities sponsored by St. Paul Lutheran Church and School. I agree with the conditions on the back of this form and hereby grant permission for my child to attend the events/activities. Parent Signature Date / / -5-

6 Conditions I (we) acknowledge that participation in any and all St. Paul Lutheran Church and School programs or events is voluntary and may involve activities that require traveling or physical exertion. We agree to the following conditions for participation in the ministries, programs and events of St. Paul Lutheran Church and School, Westlake, OH. I hereby authorize any licensed physician, medical technician, hospital or other medical or health care facility to treat the minor named on reverse side for the purpose of attempting to treat or relieve any injury received by said minor. I authorize any such medical provider to perform all procedures deemed medically advisable in attempting to treat or relieve any such injuries. I consent to the administration of the anesthesia as deemed advisable. I realize and appreciate that there is a possibility of complications and unforeseen consequences in any medical treatment, and assume any such risk for and on behalf of myself and said minor. I understand that attempts will be made to contact me in the most expeditious way possible. Permission is also granted to St. Paul Lutheran Church and School representative(s) to provide needed medical emergency treatment to the student prior to his/her admission to a medical facility. St. Paul Lutheran Church and School is not responsible for the loss or theft of personal belongings. I hereby take the following action for my child, myself, my executors, administrators, heirs, next of kin, successors, and assigns: A) I waive, release and discharge from any and all claims or liabilities for personal injury of any kind or death which arise out of or relate to my child s participation in the events and programs of St. Paul Lutheran Church and School of Westlake, OH, the following person or entities: St. Paul Lutheran Church and School of Westlake, OH, its pastors, staff, employees, members, volunteers, representatives, subcontractors, and agents of any of the above; B) I agree not to sue any of the persons or entities mentioned above for any claims or liabilities that I have waived, released, or discharged herein; and C) I indemnify and hold harmless the person or entities mentioned above for any claims made or liabilities assessed against them as a result of my child s participation in St. Paul Lutheran Church and School related activities. I hereby assume the risk of my child's participation in all St. Paul Lutheran Church and School ministry activities and programs. Misconduct may result in the transportation home of my child from an activity at the parent/guardian s expense. A participant sent home for disciplinary reasons will NOT receive a refund of the activity fee. Participation in St. Paul Lutheran Church and School events or programs is a privilege and this privilege may be denied by a St. Paul Lutheran Church and School staff member when, in their opinion, the participation of that youth is disruptive and not in keeping with the mission of St. Paul Lutheran Church and School. THIS FORM IS VALID UNTIL SEPTEMBER 1,

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