Please read through this document before you fill out the paperwork. Student Paperwork Packet Instructions We re looking forward to serving with you this summer. Part of getting ready for your trip includes completing paperwork. Please make sure that you and your parent or guardian are reading though these documents carefully so you know how to plan and what to expect on your mission trip. Forms we need you to complete, sign and return to your Trip Leader: Please fill out the forms and return to by. (Trip Leader Name) (Date paperwork needs to be turned in.) Participant Release Form Site Specific Release Form If your site has specific release forms they will be here. Some of the service partners we work with require additional release form documentation. Youth Covenant Additional forms to read before you pack your bag for the week: Clothing Policy Packing List Other information to be aware of: Background Check We require that a background check be completed on all participants 18 and older (adult or student). If you will be 18 at the time of your mission trip, please inform your Trip Leader and they will handle the details around this process. Communication & Cell Phones Trip Leaders will set up a communication with family and church members before the trip so you know how to get a hold of your student while they are away. We will support your church policy for students to leave their phones at home, but we cannot promise that other groups will do the same. If your Trip Leader gives permission to bring cell phones, YW does have guidelines for their use; you can find those in the Youth Covenant. Dietary Concerns and Food Allergies We are committed to offering a variety of food choices during the week. We recommend that participants with allergies or special dietary needs bring supplemental food for the week. Please direct additional questions to your Trip Leader; YouthWorks will work with them to get answers to your questions. 800.968.8504 Page 1 youthworks.com
Bring original form and 2 copies to site Participant Release Form Youth Trips & Youth Beyond Trips Name of Participant (please print): Dates Attending: Church Name: Trip Leader: Name of Site: Grade as of Fall 2014 (if student): Liability Release Agreement I/we understand that there are inherent risks involved in any mission trip activity, and I/we hereby release YouthWorks, its staff and volunteer workers from any and all liability due to any injury, loss or damage to person or property that may occur during the course of my/our involvement with the YouthWorks organization. I/we understand that during the week participants may be photographed or recorded and I authorize and agree to YouthWorks unrestricted use, reuse and distribution of images and recording including but without limitation for purposes of promoting and publicizing the mission trip. I/we understand that use of such materials will be without compensation or our/my approval rights any time thereafter. Transport Home Agreement for Students I/we, the undersigned, as the parents having legal custody or the legal guardians of the above named participant, a minor, have given our consent for him/her to attend a mission trip operated by YouthWorks, or are of legal consenting age myself. I/we understand that a member of the YouthWorks staff or an adult leader of our group may need to send a student home as a result of illness, discipline issue or policy violation. I/we understand if the participant named above is dismissed from the mission trip, I/he/she will be transported home at my/our expense. YouthWorks or an adult leader of our group will attempt to contact the parent or guardian to arrange such transportation. Medical Release Agreement I/we the undersigned, as the parents having legal custody, or the legal guardians of the above named participant, a minor, have given our consent for him/her to attend a mission trip operated by YouthWorks, or are of legal consenting age myself. In the event that I/he/she is injured while attending the mission trip and requires the attention of medical personnel, I/we consent to any reasonable medical treatment as deemed necessary by a qualified medical professional. In the event treatment is called for, which a medical professional and/or hospital personnel refuses to administer without my/our consent, I/we hereby authorize, an adult leader of our group, or a member of the YouthWorks Site staff to give such consent for us if I/we cannot be reached by telephone at one of the numbers listed below, or because of an emergency, there is not time or opportunity to make a telephone call. In the event it becomes necessary for that person to give consent for us, I/we agree to release and hold them harmless of any claims, demands or suits for damages arising from the giving of such consent so long as the treatment is administered by or under the supervision of a medical professional. I/we also acknowledge that I/we will be ultimately responsible for the cost of any medical care should the cost of that care not be reimbursed by the health insurance carrier. Further, I/we affirm that the health insurance information provided below is accurate at this date and will, to the best of my/our knowledge, still be in force at the time of the mission trip. 800.968.8504 Page 1 youthworks.com
Emergency Contact Information (please provide two) Bring original form and 2 copies to site Participant Release Form Youth Trips & Youth Beyond Trips Name: Relationship to Participant: Home Phone: Work Phone: Cell Phone: Name: Relationship to Participant: Home Phone: Work Phone: Cell Phone: I understand and acknowledge that participation in a YouthWorks mission trip is contingent upon compliance with all the policies stated on the previous page: Liability Release, Transport Home and Medical Release Student Participant Print Name: Signature: Date: Parent/Guardian (1) Print Name: Signature: Date: Parent/Guardian (2) Print Name: Signature: Date: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OR - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Adult Participant Print Name: Signature: Date: 800.968.8504 Page 2 youthworks.com
Bring original form and 2 copies to site Participant Release Form Youth Trips & Youth Beyond Trips In compliance with HIPAA privacy laws, the section below will be detached and disposed of after completion of your trip. Medical Information* Participant Name: Date of Birth: / /. Home Address: Phone: Date of Last Tetanus Shot: Known Allergies: Current Medications or Health Conditions: *To be used only to determine course of treatment in the event of a medical situation. Insurance Information* Name of health insurance company: Health insurance group number: Phone/address of health insurance company: Name of policy holder: Policy holder s phone number: Health insurance policy number *Participants without health insurance are still able to attend, understanding the risks and personal liability to any and all medical payments. *Please attach a copy of your insurance card to this form. It will be destroyed after attendance is completed. 800.968.8504 Page 3 youthworks.com
Bring Signed Form to Site YOUTH COVENANT You re about to meet some new people in a new place and hopefully learn some pretty incredible stuff! But before you do, there are a couple things we want everybody to agree on, so your trip will be the best it can be. We ve thought carefully about what s important for everyone to see eye-to-eye on and listed those things below. These expectations will help to make this experience meaningful, fun and safe for everyone and by everyone, we mean YouthWorks staff, community members, adult leaders, other students and, especially, you! Please read this covenant carefully so you understand YouthWorks policies. By signing at the bottom, you ll be agreeing to respect the community you are serving and commit to being a team player in your group.! I agree to look for ways to serve others with a joyful attitude, so I can help people like Jesus did. I understand that I am on the trip to serve God, help a community, build new relationships and learn new things. I agree to come prepared to do just that!! I am aware that my actions affect people other than just me. I agree to obey all local laws and ordinances pertaining to use of drugs and alcohol by minors. I will not bring or use any weapon or illegal substance during my mission trip week.! I want to stay focused on the people and experiences at the mission site. Out of respect for the policies of YouthWorks ministry and housing partners, I will consider leaving my cell phone at home. If I choose to bring my cell phone, I understand that I will only be allowed to use it during approved times, and I will risk theft or loss. I understand that my parents will be given instructions on how to contact my adult leaders in case I need to be reached.! Because I want nothing to distract me in this week of serving others, I will consider leaving electronic devices at home. This includes ipods, mp3 players, electronic games, laptops or any other devices that could cut me off from interacting with those around me or prevent me from fully engaging in activities. I understand that I will not be able to use these items during the week and that I risk theft or loss by bringing them.! I want to respect the people around me, so I agree to follow the YouthWorks Clothing Policy. The way I dress can affect my ministry. I will respect my group, the community and myself by dressing modestly.! I agree that this mission week is a group experience. I ll be in different group settings all week. Because of this, I will do my best to build community, create relationships, be welcoming and include others. I agree to treat everyone leaders, staff, other students and community members with the utmost respect.! I realize that there are adults in my life and on the trip who care about my well-being. Plus, I want to be safe! So, I agree to stay within the designated YouthWorks boundaries, follow rules at ministry sites, stay in groups of three or more, respect gender-specific areas (sleeping rooms, restrooms and showers), and refrain from using my cell phone in these areas due to privacy concerns.! It matters how I treat people s things, so I agree that I will respect the property of all participants, the community members and the housing site where we stay. My actions will show my love for Jesus and others. I will keep in mind the purpose of the trip and my job of showing Jesus to the community. I agree to follow all the above expectations because I want to be safe, love others and represent Jesus well at all times. Student Signature Date Parent/Guardian Signature Date YouthWorks 2015 Youth Covenant
CLOTHING POLICY YouthWorks loves the community where you are serving this summer! As you serve, your actions and appearance speak loudly and have the potential to influence the community s perception of YouthWorks and more importantly Christ. Choosing modest clothing helps to avoid distractions and misunderstandings. We ask that you choose apparel consistent with the following guidelines. Please Bring Mid-Thigh or Longer Shorts (or pants) You will bend, twist, sit, climb and crawl as you love and serve communities. Short shorts will only get shorter with these activities. Here s how we define short: Let your arms fall to your side if your fingers touch skin, bring a longer pair. Loose-Fitting Clothing During the week your clothes may endure paint, sweat, mud and lots of love from children! Bring clothes that you can work and play hard in. Tennis Shoes or Work Boots (Closed Foot Shoes) To prevent injury, you need to bring a pair of shoes that completely cover your foot. Bring tennis shoes or work boots that you don t mind getting dirty or wet at work sites and that you can wear in the kitchen. One-Piece Swimsuits Some YouthWorks sites include swimming activities. Please choose modest, one-piece, swimsuits for these occasions. If you do not bring a one-piece for swimming, you ll be asked to wear a dark t-shirt over it. Please note that although we won t swim at every site, swimsuits are a good idea for additional privacy in the showers, in these instances it is OK to wear a twopiece. Please Don t Bring Apparel that distracts... Tank tops or sleeveless shirts Short shorts including the recently popular running/track shorts Clothing that reveals undergarments, midriffs or chests Tight-fitting clothing including leggings, yoga pants, etc. Also, apparel that... Includes obscene, vulgar, abusive or discriminatory language or images Advertises or promotes alcohol, chemical, tobacco or any other product illegal for use by minors Represents hate groups, is gang-related, or contains threatening language Why Not? We represent Christ in the communities that we serve. While community members may choose to wear these clothing items, we know that our wearing them often work against our efforts to serve as the hands and feet of Jesus and so ask you to refrain. This distracting apparel can be disrespectful and damaging to our long-term relationships. We don t want to be the clothing police and we know that you don t want us to be either. We ask for you to understand this clothing policy and follow it. YouthWorks staff will ask the adult leaders to enforce the policy by asking you to change your clothing if it is believed to be a distraction. We appreciate your help in creating a safe, respectful, distraction-free environment for your mission experience. YouthWorks 2015 Clothing Policy
PACKING LIST For Everyone Reusable water bottle (extremely important!) YouthWorks provides drinking water. Sun block, lip balm, hat (to protect you from the sun), sunglasses Long pants (for cool nights and/or work projects)* Long sleeved shirts and sweatshirts (for cool nights and/or work projects)* Short sleeved shirts (no sleeveless shirts or tank tops see clothing policy) Appropriate length shorts (see clothing policy) Nice, clean clothes for a possible worship service* Light jacket (for cool nights)* Tennis shoes or work boots (closed-foot shoes) Underwear and socks One-piece swimsuit for showering and possible evening activities (see clothing policy)* Bath towel, washcloth Shower shoes (flip-flops) Small shower bag or backpack Soap, shampoo, deodorant, other toiletries (extra contact lenses, backup pair of glasses) Sleeping bag and pillow Air mattress or camping pad (we will sleep on floors)* Must be twin size or smaller Bible and pen Spending money for snacks and t-shirt purchases (talk to your Trip Leader for further details) Insect repellant (not every person needs to bring coordinate with others in your group)* Flashlight Battery powered alarm clock (not every person needs to bring coordinate with others in your group) Reusable lunch bags/boxes for lunches (YouthWorks does provide brown paper lunch bags, but bringing your own can save on waste) *The Site Director will connect with your Trip Leader to talk through specific packing list items during the Pre-Trip Call, 2-3 weeks before your trip. Notes on Packing Because space is limited in the sleeping rooms, everything but your sleeping bag and camping pad or air mattress must fit in one duffel bag or suitcase. Please check the local weather forecast for your site to make sure that you pack accordingly. DO NOT BRING: Blow dryers, curling or straightening irons because the shower time is short and because many of our housing sites do not have the power to run all of these small electronics at one time. ipods, electronic games, other valuables, or too much cash. These items can distract you from others during the week and may be susceptible to theft. YouthWorks is not responsible for any lost or stolen items. For Canadians going to US Sites or US citizens going to Canadian Sites Appropriate documents for border crossing See Border Crossing Info under Required Paperwork Be sure to exchange your money before mission trip. This can take up to a few weeks. For those going to Puerto Rico Because of space limitations, do not bring an air mattress! Please bring a foam pad or camping pad. (Buying something? We suggest: bit.ly/camppad) The summer is rainy season in PR a small umbrella or raincoat is a good idea and bug spray mandatory! We will be attending a Puerto Rican church service while you are on site. It is important to be culturally appropriate in our clothing, which means to dress modestly. YouthWorks staff will ask participants to change if they are not dressed appropriately. Suitable clothing for church includes: For women: At least knee-length skirts/dresses or shorts/capris and a nice loose-fitting shirt. Please no sleeveless dresses. For men: Pants or knee-length shorts, preferably khakis with a short sleeve button-down shirt or polo shirt. Sandals are appropriate for everyone to wear to church. YouthWorks 2014 Packing List