Shepherd of the Valley Junior High Mission Trip Application Quad Cities Sunday, June 15 Friday, June 20, 2014
Dear Junior High Student and Parent: We have the exciting opportunity to fill 50 mission trip spots to the Quad Cities the week of June 15 - June 20. We will leave the morning of Sunday, June 15th and return on Friday, June 20th. We will be partnering with YouthWorks. Based on past positive experiences with YouthWorks and their core purpose, we feel that this is a perfect way to provide LIFE CHANGING, CHRIST-CENTERED YOUTH MISSION OPPORTUNITIES for SOV Junior High students this summer. Deposits - Deposits are required to reserve a spot. A $75 deposit is required if the spot is reserved before December 19, 2013. $125 deposit required if reserved after December 20, 2013. Deposits are non-refundable. After February 12, students are responsible for the total cost of the trip if he/she cancels. With approval from SOV leadership, a replacement can be found. Our first Quad Cities Mission Meeting for students (not parents) will be on Wednesday, February 12 from 8:00-8:45PM. Application packets are due on Wednesday, February 12 at the meeting. More information about the trip: This mission trip will provide students with an opportunity to serve in a variety of ways. Upon arrival, students will be assigned to a variety of service opportunities that may include children's programs, elderly centers, soup kitchens/homeless shelter, thrift stores, etc. During the evenings the students will have an opportunity to participate in fun activities, and one day will be dedicated to a surprise activity for the students. Additional information about YouthWorks is available at: http://www.youthworks.com/about/index.asp Short Term Missions Change Lives: YouthWorks believes short term youth mission trips can bring life change to youth, a community and the Church. Within a relatively short period of time, a student s life and a stranger s life can be powerfully changed through the desire to give to a community. A student s presence during a mission trip speaks more than a thousand words through their simple love and willingness to serve. YouthWorks believes in stories in telling Jesus story, in listening to other s life stories and in bringing our stories together to transform hearts; a mission trip is the perfect time to tell those stories. There are countless physical and spiritual needs in communities today in our own backyards, across the country, in big cities, on Reservations, in small towns, and across borders. Short term missions are a means to visualize needs in other communities and bring that recognition back to serve in your own home. After a week spent in service, students will leave transformed from the love, strength and resilience found in those they meet. Short term missions are often more life changing and impacting for participants than those they came to serve! We are very excited about this mission opportunity! Grace and Peace, Sam Dittrich Student Ministry Director Shepherd of the Valley Lutheran Church
Typical Schedule for the Quad Cities YouthWorks site: Sunday 6:00 pm Groups Arrive 6:30 pm Supper 7:00 pm Leader s Meeting / Youth Orientation Meeting 8:30-9:30 pm Club (an interactive time led by our staff) 9:30-10:30 pm Church Group Time (a time to process the day as a group) 11:15 pm Lights Out Monday through Friday 6:45 am Breakfast Team Prepares Breakfast Buffet 7:00 am Wake Up 7:15-7:45 am Breakfast Buffet Open (Everyone packs their own lunch) 7:45-8:15 am Get Dressed, Etc. 8:15-8:40 am Personal Devotions/Quiet Time to Prepare for the Day 8:40-8:45 am Entire Group Gathers for Prayer 9:00 am Depart for Work Ministry Sites Noon Lunch at Site 1:00 pm Work at Ministry Sites 3:45 pm Clean up the Work Ministry Sites 4:00-5:30 pm Shower Time (Dinner team prepares meal) 5:00-5:30 pm Adult Leaders Meeting 5:30-6:30 pm Dinner and Cleanup 6:30-8:30 pm Evening Activity (as a whole group) 8:45-9:45 pm Club 9:45-10:30 pm Church Group Time 10:30-11:00 pm Free Time/ Prepare for Bed 11:15 pm Lights Out Friday afternoon we will enjoy a surprise activity as a group. We will return to SOV the evening of Friday, June 20, 2014.
Payments / Mission Team Meeting Schedule The total cost of the trip is $450 ($400 if registered before 12/19/13) which will cover: Round trip transportation, accommodations, majority of meals, and ministry materials. Extra money will be needed for food stops on the way to the Quad Cities and the return trip. (approximately 3-4 meals/snacks) Student Team Meetings All pre-trip prayer and ministry preparation meetings are mandatory. Attendance by each team member is crucial to the success of the team. Not only are these meetings scheduled to give you important information to prepare you practically for your ministry, but they are also designed to establish strong team unity through prayer and relationship building. Please commit to attending all team meetings. Parents are required to be at ONE meeting on Wednesday, April 9, 2014. Meeting and Payment Schedule Deposit Due / Non-Refundable $75 / $125 Before December 19 / After December 20 LAST DAY TO REGISTER Wednesday, January 15, 2014 Meeting / Application Due Wednesday, February 12 8:00-8:45 pm Meeting / 2nd Payment $100 Wednesday, March 12 8:00-8:45 pm Meeting / 3rd Payment $100 Wednesday, April 9 8:00-8:45 pm (Mandatory Paperwork & Parents) Meeting / 4th Payment $125 Wednesday, May 7 8:00-8:45 pm MISSION TRIP Sunday, June 15 - Friday, June 20, 2014 Debrief Sunday, June 29 10:00-11:00 am The first deposit/payment of $125 will be due Wednesday, January 15, 2014 by midnight. (If you register before 12/19/13 you will save $50) Deposits are non-refundable. After February 12, students are responsible for the total cost of the trip if he/she cancels. Our first Quad Cities Mission Meeting for students will be on Wednesday, February 12 from 8:00-8:45 pm. Application packets are due on Wednesday, February 12. If you feel called to be a part of this missions team and finances are an issue, please contact Sam Dittrich to discuss solutions. This following Application Packet is due on Wednesday, February 12, 2014. Space is limited and on a first come, first serve basis.
Application Packet Parental Consent, Certification and Medical Authorization This form must be completed by all team members under 18 years of age. Parents and legal guardians of minors are asked to complete this form and bring it to the meeting on 2/12/14. Shepherd of the Valley 14107 Hudson Road South Afton, MN 55001 General Information (please print) Student s Name Date of Birth Father s Name Mother s Name Student s Address Home Phone Parent s Cell Phones Emergency Contact Emergency Contact Phone Insurance Company Covering Student Policy Number Please make a copy of both sides of your insurance card and submit with this form. Consent and Certification I/we, the undersigned, being the parent or legal guardian of the student named above (the student ), do hereby consent to the student s assignment on and participation in an outreach sponsored by Shepherd of the Valley Lutheran Church, including but not limited to, all of the activities customarily associated with a Shepherd of the Valley Lutheran Church missions trip. I am aware of the hazards and risks associated with such a trip including, but not limited to, death or injury by accident, disease, terrorist acts, weather conditions, inadequate medical services and supplies, criminal activity and random acts of violence. I/we hereby release Shepherd of the valley Church, its agents, employees and volunteers from any liability whatsoever arising out of injury, sickness or damage which may be sustained by said student during the course of said trip. I understand that while the above named student participates in any Shepherd of the Valley Lutheran Church activity, he or she is responsible to abide by the rules set forth by Shepherd of the Valley Lutheran Church and to comply with all orders and directives of Shepherd of the Valley Lutheran Church supervisors (be they staff or volunteer). Any infraction of the rules by the student can result in dismissal from the program. In the event the student is dismissed, I/we, the undersigned, agree to assume the cost and inconvenience of returning the student to his/her home. I also agree to forfeit any right to a refund of pre-paid fees or expenses. Signature of Parent/Guardian Date Signature of Student Date
Medical Questionnaire Is your student presently being treated for an injury or sickness or taking any form of medication for any reason? Yes No (If yes, please explain) Is your student allergic to any medication? Yes No Are they bringing medication with them? (if yes, please explain) Does your student require a special diet? Yes No (if yes, please explain) Does your student have any allergies other than medical? Yes No (if yes, please explain) Can your student swim? Yes No Does your student have any physical condition or illness that would prevent him/her from participating in rigorous activity? Yes No If yes, explain below and a written release must be submitted by your physician authorizing your student to participate in this activity. Medical Treatment Authorization I understand that I will be notified in case of a medical emergency involving my child. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I authorize the team leader or properly appointed staff member or volunteer to make emergency medical care decisions on behalf of my child, if required by law or health care provider. I agree to notify Shepherd of the Valley Lutheran Church in the event of any health changes which would restrict my child s participation on this mission trip. I also understand that the adult supervisor s reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child. Student Code of Conduct The following are guidelines and expectations of the Youth Ministry at Shepherd of the Valley Lutheran Church. These need to be understood and accepted before participating in any event or activity. Please read through completely and if any guidelines and expectations are unclear or unreasonable, please contact the Youth Staff prior to leaving for the event. I will respect others and their property and the property that we are using during our event. I understand that I am part of a Christian community. I will be an active participant and be on time for all activities and group meetings. I will respect staff, leaders, student participants, etc. I will not bring or use any non-prescribed drugs, alcohol or tobacco during any event or Shepherd of the Valley sponsored activity. I will not engage in inappropriate sexual conduct. I have read the above expectations and I will make a commitment to follow them during the event. I understand that I may be sent home as a result of illness or discipline problems. Signature of Parent/Guardian Date Signature of Student Date
Application Questions Junior High Students: Please fill this out and submit with the application packet on Wednesday, February 12, 2013. Briefly share your faith journey. How has God impacted you? What role does Jesus have in your everyday life? What serving experience do you have? Include previous mission trips, ministries you served in, or leadership opportunities. Note: serving experience is not required to participate. Why do you want to participate in this mission opportunity? What do you hope to gain by going on this trip?