July 11 th through July 25 th

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1 Detroit: Michigan Cost: $845 Registration Begins: April 1 st, 2015 To Apply: Fill out application & turn it in with your 2 references and $50 non-refundable deposit. You will be notified of your acceptance. Please answer all the questions thoroughly and honestly. July 11 th through July 25 th Participant Application Name Birthdate: Street Address City FL Zip Phone Current Grade in School Cell Phone #: Parents Names: T-Shirt Size (circle one) S M L XL XXL What s the difference between mercy, justice and grace? Help me briefly understand all three. Make sure to have a parent read through and sign this application. You too! If you have any questions, please do not hesitate to call the office and ask for Cassandra or Whitney. ( ) Does VBS in Detroit make a difference? Tell me why or not specifically.

2 One author writes, There is a certain amount of ego satisfaction in being known as frontline troops who place themselves in harm s way to liberate a territory taken over by evil forces. What do you think the author means here? How could this potentially be us? One danger is that we get consumed with being initiators in the community. But the real need is for us to be learners. What do I mean by this and how can we do this? One author writes, One of the surest ways to destroy the self-worth of an inner city person is subsidizing the idleness of able-bodied people. What does he mean and how might we avoid this? We talk about many of the weaknesses of Detroit. Name 2-3 strengths of Detroit specifically seen in and around our local Detroit community. List for me 2-3 specific, measurable, realistic goals you have for Detroit this summer while you re there. No more than one can be about you.

3 Mission trips often get called Christian tourism. We go to Detroit repeatedly for a reason. If we want to substantial change in a troubled area or neighborhood, we must concentrate energies and resources there over time. What do you think I mean? What do you think are the 2-3 greatest needs in our local neighborhood in Detroit? Be specific. Do you realize you ll be expected to pray out loud in the community and within our group? YES NO Do you realize we ll be studying God s Word and your input is anticipated during the discussion? YES NO Do you realize this trip is relationally based, not only with our group but with the community? YES NO Read and sign the following as a part of your agreement of responsibility: I promise to participate in the preparation process and keep the financial and time commitments established by Edgewater Alliance Student Ministries. I will not complain during the project and will do my best to have a servant s attitude I will obey all leadership on my project I will not use profanity I will not use and/or purchase alcohol, drugs or tobacco on the project I will adhere to the dress code established by Edgewater Alliance Student Ministries and our partners in Detroit I will follow safety precautions during the project I understand that if I break the terms of this agreement, my leaders may choose to send me home at my own expense. I understand that I (my child) will be expected to raise funds, attend team meetings, and submit to Edgewater Alliance Church s project leadership. We understand that this is a mission trip and that we need to make preparations to empty all calendar items from the participant s schedule for all team meetings and during July 11 - July 25, We agree and understand that there may be additional responsibilities beyond team meetings such as preparations for VBS or fundraisers, etc. I agree to adhere to the dress code that has been established for this trip. I agree that I will be a positive role model in conduct and speech while on this mission project. Applicant s signature Date Parent s signature (if under 18) Date

4 Participant Reference #1 Name of Participant: Please return form by: To: Edgewater Alliance Student Ministries 310 North Ridgewood Avenue Edgewater, FL Reference Thank you so much for serving as a reference for an EASM Missions Applicant. Your insight is important in the application process. Please answer the questions below to the best of your knowledge and return this completed form to the group leader at the address above. Your Name: Phone: Relation to participant: How long have you known the applicant? Please evaluate the applicant on each of the following qualities to the best of your knowledge according to the provided scale (1 = poor, 10 = excellent) Honesty Teachable Compatibility with Others Respect for Authority Spiritual Maturity Trustworthy Ministry Skills Heart for Missions Interpersonal Skills Flexibility Are you aware of any weaknesses in the participant that give reason to question his/her ability to be a positive contributor to a short-term mission project? Please explain. Please summarize how you feel the applicant would perform on a mission project. Based on the information above, this applicant is: Strongly Recommended Recommended with some reservation as noted above Please Explain (Feel free to use the back of this reference as needed): Recommended Not Recommended Signature Date

5 Participant Reference #2 Name of Participant: Please return form by: To: Edgewater Alliance Student Ministries 310 North Ridgewood Avenue Edgewater, FL Reference Thank you so much for serving as a reference for an EASM Missions Applicant. Your insight is important in the application process. Please answer the questions below to the best of your knowledge and return this completed form to the group leader at the address above. Your Name: Phone: Relation to participant: How long have you known the applicant? Please evaluate the applicant on each of the following qualities to the best of your knowledge according to the provided scale (1 = poor, 10 = excellent) Honesty Teachable Compatibility with Others Respect for Authority Spiritual Maturity Trustworthy Ministry Skills Heart for Missions Interpersonal Skills Flexibility Are you aware of any weaknesses in the participant that give reason to question his/her ability to be a positive contributor to a short-term mission project? Please explain. Please summarize how you feel the applicant would perform on a mission project. Based on the information above, this applicant is: Strongly Recommended Recommended with some reservation as noted above Please Explain (Feel free to use the back of this reference as needed): Recommended Not Recommended Signature Date

6 Name: Project and Date: Detroit, MI July 11 th July 25 th, 2015 Church: Edgewater Alliance Church Trip Leader: Cassandra House Parent/Guardian; Phone: Emergency Contact (if Different): Relationship: Phone: Students Social Security Number: Date of Birth: Insurance Information Company: Policy Type: Policy:#: Medical Information For Completion by Physician (Please attach another sheet of paper if needed.) Will the student by bringing any prescription medication on the project? What Kind? For what condition? Date of last physical examination: Date of last tetanus shot (this must be within 10 years): Date of Hepatitis A inoculation (this is NOT required, but recommended): List any physical disabilities or limitations: List any major illnesses in the past Year: List any known allergies or reactions: Has the student ever fainted or passed out? when? why? Does the student have any eating disorders? If yes, has (he/she) received counseling? Other conditions of which EASM should be aware: I have examined and find him/her to be in good general health and physically able to take part in the EASM project to Detroit, MI from July 11 th through July 25 th. Doctor s signature: Date: Parent Release (if under 18): To be signed by parent in the presence of a Notary Public As the parent or legal guardian of (student), I give my permission for him/her to participate on the Edgewater Alliance Student Missions project to Detroit, MI from July 11 th through July 25 th, In an emergency, illness, injury, or accident which requires medical attention, I give my permission to Edgewater Alliance Student Ministries, it s representatives and all attending health care professionals (defined as including, but not limited to registered nurses, licensed practicing nurses, physician s assistants, doctors and paramedics) to receive medical treatment, to hospitalize, anesthetize, or perform surgery on my child named above. I understand that every effort will be made to contact me before these actions are taken. I, (parent), the undersigned to release, acquit, discharge and covenant to hold harmless Edgewater Alliance Student Ministries, and it s paid and volunteer staff from all actions, damages or liabilities arising out of the treatment of any illness, injury, or accident incurred during my child s participation on the trip. It is the intention of this release that the above Edgewater Alliance Student Ministries and its paid or volunteer staff incur no liability whatsoever while attempting to meet all medical needs that my child may require during the project. Parent/Guardian Signature Relationship: Date: State of, County of. Sworn to and subscribed to me this day of, 201. Notary Public Signature: My commission expires: