SUMMER FRIDAYS on the E.D.G.E. REGISTRATION FORM

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Jemimah Strickland
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1 SUMMER FRIDAYS on the E.D.G.E. Join hands this summer to take a message of hope and love from the E.D.G.E. to others outside our walls! Register for our second annual summer of service projects. You may register for 1, 2, 3 or all 4 projects, but must attend at least ONE to participate in our end-of-summer celebration (details to come). All registration forms and fees must be returned NO LATER THAN Thursday, June 21. Make checks payable to LLUMC with Summer Fridays in the memo. Fees cover homemade breakfast, on-site refreshments, and lunch on the go. Please dress appropriately in clothes that can get potentially dirty and always wear sneakers. PROJECT ONE: FRIDAY, JUNE 22 MISSION CENTRAL RELIEF KITS MECHANICSBURG, PA - $10 Must wear closed-toe shoes. Warehouse work and relief kit assembly such as flood buckets, school kits and hygiene kits. Meet in Fellowship Hall for breakfast at 8:30 a.m. Project work from10 to1 p.m. followed by fast-food lunch and return to LLUMC for pick-up by 3:15. PROJECT TWO: FRIDAY, JULY 13 THE NEIGHBORHOOD CENTER HARRISBURG, PA - $10 Meet in Fellowship Hall for breakfast at 9:00 a.m. We will be preparing LUNCH in our LLUMC kitchen for nearly 100 underprivileged kids who call the Neighborhood Center their summer care center. We will prepare, deliver, serve and clean-up lunch. We will also join the children and eat lunch with them on this day. On our way back to LLUMC we will stop for ice cream. Pick-up 3:00. PROJECT THREE: FRIDAY, JULY 20 CENTRAL PA FOOD BANK, HARRISBURG, PA - $10 We will work at the warehouse of the Central PA Food Bank, moving food boxes, pallets, organizing shelves and more. Must wear closed-toe shoes. Our work time is 9:30 to 12:30, followed by lunch at Infinito s Pizza and Pasta Buffet, then return to church for pick-up by 3:00. PROJECT FOUR: FRIDAY, AUGUST 3 ON-SITE SET UP HELP FOR LLUMC PEACH FESTIVAL FOLLOWED BY TAILS AND TRAILS TRAIL RIDES, DILLSBURG, PA- $10 For your calendars: LLUMC Peach Festival, Saturday, August 4! Dress for the weather and to get dirty. Wear sneakers. T & T is a non-profit facility that offers camps, trail rides and more to kids in a variety of situations.

2 SUMMER FRIDAYS on the E.D.G.E. REGISTRATION FORM NAME OF YOUTH (PLEASE PRINT): S USED TO REACH YOUTH AND PARENT: PLEASE REGISTER ME FOR THE FOLLOWING SERVICE PROJECTS: PROJECT ONE: FRIDAY, JUNE 22 MISSION CENTRAL, MECHANICSBURG, PA PROJECT TWO: FRIDAY, JULY 13 THE NEIGHBORHOOD CENTER, HARRISBURG, PA PROJECT THREE: FRIDAY, JULY 20 CENTRAL PA FOOD BANK, HARRISBURG, PA PROJECT FOUR: FRIDAY, AUGUST 3 ON-SITE SET UP FOR LLUMC PEACH FESTIVAL & TAILS AND TRAILS TRAIL RIDES, DILLSBURG, PA $ TOTAL FEES ENCLOSED. PLEASE MAKE CHECKS PAYABLE TO LLUMC WITH SUMMER FRIDAYS IN THE MEMO. THANK YOU. Registration materials are due NO LATER THAN Thursday, June 21. Drop them in the Childrens Min/Youth Mailbox located in the hallway of the administrative offices of Linglestown Life (OR) return them by mail to: Sarah Axtman, EDGE Youth Ministry, 1430 North Mountain Road, Harrisburg, PA, Your registration is NOT COMPLETE until ALL OF THESE ITEMS HAVE BEEN RETURNED: (1) Registration form (2) Fees (3) Parent consent, medical waiver form and emergency contact info (4) Medical history form (5) Conduct covenant

3 PARENT CONSENT FORM and MEDICAL WAIVER (please print in ink) Name of Youth DOB Age Grade Fall 12 Cell phone YOUTH Address Home Phone Number Cell phone PARENT I give permission for (name of youth) to attend and participate in any of THE LINGLESTOWN LIFE E.D.G.E. YOUTH GROUP SUMMER FRIDAYS SERVICE PROJECTS to be held at various locations on JUNB 22, JULY 13, JULY 20 AND AUGUST 3. I the undersigned have legal custody of named youth, a minor, and give consent for him/her to attend these events, understanding that there are inherent risks involved in any project or athletic event. I hereby release Linglestown Life UMC, its pastors, employees, agents, and volunteer workers from any and all liability for injury, loss, damage to person or property that may occur during the course of this youth s involvement. Medical Treatment Release and Liability Release: I hereby authorize event staff to obtain and give consent for medical treatment for my child for such injury or illness that may occur during these events, and hereby hold the event staff and their representatives harmless in the exercise of this authority. In the event medical intervention is necessary, every attempt will be made to immediately contact the person listed on this form. I give permission for my child to be transported in vehicles operated by the adults in whose care the minor has been entrusted while attending and participating in this event. It is my understanding that the above named participant will be covered by my personal medical insurance. Payments of any medical injuries not covered by my insurance or the event limited/supplemental medical insurance, if any, will be paid by me. Further, I affirm that the health insurance information provided is accurate at this date and will, to the best of my knowledge, still be in force for the youth named above. I also agree to bring my youth home at my own expense should they become ill or if deemed necessary by the youth director or other adult leaders. Name of parent/guardian (PLEASE PRINT) Signature of parent/guardian DATE Medical Insurance Carrier Group No. In the event Linglestown Life Summer Fridays adult chaperones cannot reach you by phone at any of the numbers provided, then the emergency contact listed below is hereby given permission by you to act on your behalf and in the best interest of your youth. Emergency contact name: Relationship to Youth: Emergency contact phone numbers:

4 Medical History If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, weakness, limitation, handicap, disability, or condition to which your youth is subject and of which the youth leaders should be aware, and what, if any, action of protection is required on account thereof. Submit this notification in writing and attach it to this form. Please detail the following areas of concern for your youth. If necessary, add another page. 1. For your youth s safety and our knowledge, are they a Good swimmer Fair swimmer Non-swimmer 2. Does your youth have ANY allergies? If so, please be specific. This is important for potential medical treatment AND food preparation. Explain: 3. My child has the following physical condition that may require special attention. Explain the special attention that may be required. ( ) Diabetes ( ) Hyperventilation ( ) Convulsions ( ) Seizures ( ) Asthma ( ) Frequent upset stomach ( ) heart trouble ( ) Other (please specify) 4. Does your child require any special accommodations or have special accessibility needs? Explain: 5. Date of last tetanus shot: 6. Does your youth wear Glasses Contact Lenses Orthodontia 7. Please list any major illnesses or medical issues your youth has experienced during the last year. Explain: 8. Should your youth s activities be restricted for any reason? Explain:

5 SUMMER FRIDAYS on the E.D.G.E. Covenant of Participation A covenant is a Biblical term that means a contract. In the Old Testament, God made numerous covenants with his people, spelling out things He expected from His people. Our Summer Fridays Covenant outlines the behavior all participants are expected to follow while at our service project sites. I will conduct myself at all times according to common standards for all Christians. I agree to be held accountable for my actions. I will not possess or use alcohol, drugs or tobacco of any kind. I will not fight, use weapons, or engage in similar dangerous activity. I will reflect God in my behavior, attitude and language. I will dress appropriately and will not wear clothing with non-christian or offensive words, pictures or logos. I will respect God s creation at all times. I will respect my neighbor s body, mind, spirit and property as well as the property where we are working. Beyond that, I will go out of my way to give compliments and encouraging words to others in the group, and be a source of Christian love as detailed in 1 Corinthians 13. I will not leave our work site at any time or for any reason, and will travel to all places we are working or relaxing with at least one buddy of the same gender. I understand that before I do that, I must ALSO inform an adult chaperone where I am going and why. I will not intentionally put myself or others in danger and will abide by the additional rules required at any work site or park we are at. I will cooperate with other members of our group and perform assigned tasks at each project without hesitation or argument. I understand that teamwork is expected and that our goal is to help others and complete a project. If I do not want to work hard, I should not attend these activities. I understand that if I violate this covenant, disciplinary action may be taken up to and including calling my parents who will be responsible for coming to our project/activity site and taking me home. Suspension from future youth group activities may also occur. The rules in this covenant can be modified or changed as needed, and additional rules may be established for a specific activity. SIGN AND RETURN (please make a copy for your own file and information) If a person does not follow the rules that have been outlined, they will be held accountable for their actions. We believe that discipline needs to carefully consider a youth s dignity and self-esteem, and while it is not an adult chaperone s desire or intent to embarrass or get anyone in trouble, the best interest of the group will take priority over anything else. By signing this covenant, you agree to abide by the rules detailed above. Your parent s signature acknowledges the terms and conditions expected of their youth, as well as the potential consequences and responsibilities if disciplinary action must occur. Youth Signature Date Parent Signature Date

6 NEXT SUMMER...ROAD TRIP!! Something to start thinking about...next SUMMER, 2012, our missions team, The Church Has Left the Building will be hitting the road. DESTINATION: Red Bird Mission, Beverly, KY DATES: July 21 to July 27, 2013 WHAT: Work Camp that will include light construction and community outreach projects at the Red Bird Mission and surrounding communities. The team will consist of 25 members and the cost is $350 each. YOUTH are invited to participate (8th grade or older) and fund raising for their costs will be planned...so DON T let that stop you from making this commitment. The fee includes air conditioned bunk houses (real mattresses :) and meals served in a dining hall. This is an intergenerational trip and an AWESOME opportunity to Love God and Love Other through service. Think about it...more to come.

2014 YouthWorks Participant Release Form Youth & Youth/Beyond Trips Bring original and two copies on your trip

2014 YouthWorks Participant Release Form Youth & Youth/Beyond Trips Bring original and two copies on your trip Name of Participant (please print): Grade as of Fall 2013 (if student): s Attending: Name of Site: Church Name: Trip Leader: Liability Release Agreement I/we understand that there are inherent risks involved