CCYM Application Packet for Adults Meeting and Event Dates

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Center for Mission Support Central Texas Conference 3200 East Rosedale Street Fort Worth, Texas 76105 817-877-5222 CCYM Application Packet for Adults February 22, 2019 Thank you for your interest in serving on the Conference Council on Youth Ministries! This team consists of youth and adults from across the Central Texas Conference who are interested in using their gifts and passions to be in ministry with and for our church. In this packet you will find a CCYM Leader application, covenant, medical release form, and important dates. CCYM leaders should be prepared to attend all scheduled meetings and retreats spread out throughout the year and in various locations. Being a part of the Conference Council on Youth Ministries is a commitment, but you will also gain leadership experience, service opportunities, have a lot of fun and grow deeper in your faith. CCYM Leader applications are due by May 1, 2019. You will be contacted via e-mail when each element of your application has been received and when your application is complete. Please be watching for emails from clairecondrey@ctcumc.org. Please note: CCYM Leaders (both adults and students) are permitted to miss up two meetings a year, with valid excuses. If a leader misses more than two meetings/events* the Executive Team has the right to remove leader from CCYM for the remaining year. *Meetings/events must be attended in their entirety in order to be counted as attended. CCYM Leaders must be a member of a United Methodist Church within Central Texas Conference Much communication happens via e-mail. You are expected to read all emails and respond promptly. Communication is vital. The app Remind is used to help the entire group keep in contact by sending out reminders about emails, upcoming events, and meetings. GroupMe is also used by the entire group to provide opportunities of further connection. Remind and GroupMe are safe apps for both iphone/android phones. (This is not a social media app.) We request leaders who have a smart phone use these apps to help improve communication. Meeting and Event Dates (locations for meetings will be given after the CCYM 2019-2020 team is established. Some travel will be required for the meetings. Travel time of two hours to meeting location is not uncommon): June 7-9, 2019 CCYM Kick Off Retreat August 24, 2019 CCYM Meeting 10am-3pm November 9, 2019 CCYM Meeting 10am-3pm January 17-18, 2020 Mock Mid-Winter February 7-9, 2020 Mid-Winter Retreat #1 at Glen Lake Camp** February 20-22, 2020 - Mid-Winter Retreat #2 at Glen Lake Camp** March 21, 2020 CCYM Meeting 10am-3pm June 12-14, 2020 CCYM Kick Off Retreat **CCYM must attend at least one Mid-Winter in its entirety. **CCYM will be charged a discounted rate of $50 per Mid-Winter. Should this present a financial burden, fees may be waived on a case by case basis.

Items Needed for a Complete Application Packet Completed application form New Members: Short letter of recommendation from pastor or youth director sent via e-mail or postal mail directly to Claire Condrey. Recommendation letter must be on or accompanied by the provided CCYM recommendation template. Applicants, please make your completed application packet available to the person writing your recommendation letter. Returning Members: simply have your pastor sign your application in lieu of a letter of recommendation. MinistrySafe Compliance form for the 2019-2020 year You will be notified by May 15, 2019 about the status of your application. Should you be accepted to CCYM in the 2019-2020 meeting your membership will not be official until your completed Permission and Emergency Release form has been received. This form will be due no later than May 25, 2019. Please send all applications to: Central Texas Conference of the UMC Attn: Claire Condrey 3200 E Rosedale St Fort Worth, Texas 76105 clairecondrey@ctcumc.org 1-888-433-6157 (fax) Peace! Claire Condrey Coordinator of Youth Ministry CCYM Covenant As a member of the Conference Council on Youth Ministries (CCYM), I am representing my conference, district and local church. I understand that membership is a privilege and I agree to abide by the following covenant. I will set an example of Christian leadership at conference, district and local church events. I will be an active participant and leader at my local church. I understand Christian leadership is servant ministry exemplified by Jesus. As a CCYM member, I am an example and not an exception. As a CCYM member, I agree to participate actively in conference, district and local church ministries. I understand that I am required to attend every meeting and if I miss more than two, I may be removed from the team. If a situation arises and I cannot make it I will inform Claire Condrey no less than one week before the meeting. Much planning and fellowship occurs virtually and I will participate in this by responding to e-mails in a timely fashion and following up on my tasks. As a CCYM member, I agree to the following at all conference and district events: I will not use or possess tobacco, electronic cigarettes, alcohol, or other abusive substances. I will not use or possess firearms, fireworks, and other weapons. I will treat other persons with respect, being positive and encouraging of others. I will respect the property that we use, churches, camps, and vehicles, being sure to leave things better than I found them. I will not use profanity. I will refrain from using or providing inappropriate music, video, and/or other entertainment. I will observe and help enforce curfew as set by the leadership. I agree to the following boundaries: Girls never in boys rooms and boys never in girls rooms. I understand no covenant can cover all offenses. Therefore, the leadership team has the authority to assess situations that arise and set other guidelines and enforce consequences as deemed necessary. I understand that violation of the above covenant can result in termination of my CCYM membership, either by my local church, District Youth Coordinator, or the Conference Youth Director. Signature Date

Conference Council on Youth Ministries Team Member Application Name: Address: Home Phone: Cell Phone: E-mail Address: United Methodist Church membership: Current role at church: Why do you feel called to serve on CCYM? What is your practice for Sabbath? How do you promote youth leadership and support your leaders who are youth at your church? If you were writing this application, what silly question would you ask? If needed, how do you redirect a youth s behavior? What is the mission of the United Methodist Church?

Please share three reasons you are a United Methodist. Help us shape the year what do you hope the CCYM students walk away with in 2020? Please finish this sentence. You might work with youth if For returning CCYM adults: I affirm this adult s participation in CCYM for the 2019-2020 year. (Name of Pastor) Signature of Pastor Date

Medical Release and Liability Form Central Texas Conference Youth Ministry Events Name of Participant Name of Legal Guardian/s Address, City, State, Zip Home Phone ( ) Work/Cell Phone ( ) Age Birthday SS# School E-mail Date of Last Tetanus Functions and Activities I understand that participating in programs, recreation and other activities of Central Texas Conference of the United Methodist Church is a privilege. Prior to my participation in such activities, I acknowledge that there are certain risks associated with these activities, including, by way of example, physical injury due to activity-related accidents, physical injury due to transportationrelated accidents, illness or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware. Sleeping Arrangements Retreats held at church facilities (ie: CCYM Kick Off): Everyone will sleep at the host church. Students will be divided into classrooms, separated by sex. Students should bring a pillow, twin size air mattresses or cots, and a sleeping bag or blankets, for individual use. Retreats held at Glen Lake Camp: Everyone will sleep in cabins at Glen Lake Camp. Students will be divided into cabin rooms, separated by sex. Students will sleep in individual twin size bunk beds. Students should bring a pillow and sleeping bag/sheets and blankets for individual use. Release of Liability By signing this Permission and Waiver Form, I expressly warrant that I am capable of withstanding both the physical and mental demands of these activities. I also expressly assume all risks to me participating in the activities, whether such risks are known or unknown to me at this time. I further release the church and its ministers, leaders, employees, volunteers and agents from any claim that I may have against them as a result of injury or illness incurred during the course of participation in these activities. This release of liability is also intended to cover all claims that members of my family or estate, heirs, representatives or assigns may have against the church or its ministers, leaders, employees, volunteers, or agents. I further agree to indemnify and hold harmless the church and its ministers, leaders, employees, volunteers, or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of myself during such activities. First Aid and Emergency Medical Treatment I recognize that there may be occasions where I may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of the church to seek and secure any needed medical attention or treatment for me including hospitalization, if in the agent s opinion such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physician(s) and other medical personnel to administer any needed medical treatment, including surgery and, again, I agree to pay for the medical treatment. I also agree to let the hospital or medical agent release myself back to the church representative after treatment.

Emergency Contacts Medical Doctor Phone Number Name#1 Relation Home Phone Work/Cell Phone Name#2 Relation Home Phone Work/Cell Phone Insurance information Carrier Policy Number Policy Holder Name Carrier Phone Number Medical History (Include special medical needs or concerns such as asthma, allergies, conditions, dietary needs, medications, etc.) Other Information that leaders should know about the adult participant: Media Release (please initial) I authorize Central Texas Conference of the United Methodist Church to publish my name and/or photograph on a website or in print media. Adult Volunteers and Employees As an adult volunteer or church employee, I hereby agree to each of the consents and waivers listed above, including the Release of Liability, as pertaining to my own participation in these activities. Signature Date All Participants Along with the leaders and other youth, I agree to conduct myself in a Christian manner. I promise to respect God, respect myself, respect other people, and respect property. I understand that my agreement holds me responsible to these things and the consequences thereof. I agree to participate in these activities of the church; participation in church activities depends on my support of this agreement. By signing this covenant, I understand that action will be taken and I am subject to be sent home if I partake in any of the following activities: possession of illegal drugs, non-prescribed medication, alcohol or tobacco products (including electronic cigarettes), possession of weapons, disrespect for authority, or any other activity that adult leaders deem as inappropriate. I covenant to strive to make each activity/trip/retreat the best it can be! Signature Date

Central Texas Conference of the United Methodist Church MinistrySafe Compliance for Conference Council on Youth Ministry In order to promote a safe environment for all children, youth and adult participants in Central Texas Conference sponsored events with children and youth, each church must certify that those working or chaperoning with children and youth are MinistrySafe certified in their local church. This includes the five steps of MinistrySafe Compliance: 1) Application, 2) Interview, 3) Reference Checks, 4) Background Check, 5) Online Training, as well as agreeing to follow the CTC approved MinistrySafe policy for ministry with children and youth. Conference Council on Youth Ministry (CCYM) Church Name Church Address Church Phone Name of Adult I, acknowledge that (MinistrySafe Safety System Administrator) (Church Name) has certified this person, who will be working with youth through the CCYM 2019-2020, has completed ALL parts of certification by MinistrySafe (see five steps listed above), and has been been approved by the local church to work with youth. We agree to indemnify, protect and hold harmless the Central Texas Conference of the United Methodist Church for any liability related to any action of any participant being sent by. (Church Name) TWO separate signatures are REQUIRED. 1. (MinistrySafe Safety System Administrator) Date 2. (Senior or Assoc. Pastor) Date **This completed form must accompany the CCYM Adult Team Member Application 2019-2020.