Info and application Packet


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Tijuana 2017 siempre para los ninos

Info and application Packet

THE BASICS

WHO CAN GO? Because of the timing of the trip and long term vision for other things that we’re going to be doing in SM, this trip is going to be available to Juniors and Seniors only. There will be a reviewing process of each application done by the SM Team.

WHAT IS SIEMPRE?

Siempre Para Los Ninos means “Always for the children.” It is a kids home for orphans and children whose families are unable to care for them. Once in the program, Siempre works to reintegrate these children into healthy and loving families. Siempre was founded in 2004 by Central Community Church in Riverside, CA.

WHAT WILL WE BE DOING?

During our time there, we will be spending the weekend working on building projects around the compound, cleaning, making meals, and when we’re not working, we’ll be spending time with the many kids there! We will be partnering with Central Community Church as we work on site at Siempre.

WHERE WILL WE BE STAYING?

During that weekend, we will be staying on site in a dorm style building. Meals will be provided each day, breakfast, lunch, and dinner. The site at Siempre is secure and safe. We will not be going off site during the weekend but will be staying on site at Siempre.

WHAT IS THE COST?

The cost of the trip is $600. This covers, airfare, vans, housing, and food for the weekend. There is a $100 deposit required to reserve your spot.

WHAT ABOUT SHOTS?

To go to Mexico it is strongly recommended that you get: Hepatitis A, Hepatitis B, Typhoid, Malaria, and Rabies As well as having all your routine shots, up to date.

Tijuana 2017

THE SCHEDULE

FRIDAY

TRAVEL Meet at church and carpool to airport Fly from Seattle to San Diego Vans pick us up from San Diego airport and take us to Siempre

4PM – Check in at Siempre 6PM – Dinner 7:15PM – Orientation 7:30PM – Free Time

SATURDAY/SUNDAY

7AM – Breakfast 8:15AM – Work 12-12:30PM – Lunch 12:30PM – Work 5:30PM – Dinner 6:30PM – Free Time

MONDAY

7:30PM – Breakfast 9AM – Check out and leave for airport TRAVEL Vans take us from Siempre to San Diego Plane from San Diego airport to Seattle Pick up at airport

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IMPORTANT DATES Sunday March 5 - Meeting #1 Sunday March 19 - Meeting #2 Sunday April 2 - Meeting #3 Sunday April 23 - Meeting #4 Sunday May 7 - Meeting #5 Saturday May 20 - Team Dinner May 26-29th – We’re in Tijuana!

WHAT’S NEXT? Pray and talk with your parents about going on this trip. Fill out this application and turn it in with a $100 deposit. Make sure parents sign the medical release, this must be filled out in order to get your spot on the team. Get your passport! If you don’t have one, download the application off the internet and follow the directions. It takes about 6-8 weeks to secure a passport, so do it ASAP. They are due by April 23rd. Get your shots and immunizations!

QUESTIONS?





If you have any questions please contact Connor Takata at: [email protected] (425) 753-6210

Tijuana 2017

TIJUANA 2017 SIEMPRE PARA LOS NINOS APPLICATION Name ______________________________ Home Phone__________________ E-mail _____________________________ Cell Phone__________________ Address _______________________________________________________ City___________________________ State ___________ Zip ____________ Sex:

Male / Female

Birthday ___________________ Age __________

How long have you been at this church? ______________________________ Do you have a passport? Yes/No Name as it appears on the Passport: _________________________________ Passport #: ______________________

Passport Expiration_________

SUBMIT A PHOTOCOPY OF YOUR PASSPORT WITH THIS APPLICATION

YOUR FAITH: 1. Briefly describe your relationship with Christ:

2. What 2 events or activities have impacted your relationship with Jesus over this last year?

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Tijuana 2017

3. Are there any current moral issues or physical conditions that could impact your involvement on a mission project? __ YES __ NO If YES, please describe

CHURCH INVOLVEMENT: 1. Describe your involvement in Student Ministries (SMT, GROUPlife, SL): (Please include the name of a leader or Pastor who knows you well)

MISSIONS INFORMATION: 1. Why do you want to serve on a mission?

2. Why do you think God wants you to go on this trip?

3. Rate yourself by 1 – 5 (with 1 being the lowest and 5 being the highest). Flexibility

1 2 3 4 5

Adaptability 1 2 3 4 5

Team Player 1 2 3 4 5

4. Please describe your weaknesses

5. Please describe your strengths

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MEDICAL AND DISCIPLINE RELEASE Short Term Trip: Tijuana Mexico (Siempre Para Los Ninos) AUTHORIZATION & CONSENT FOR TREATMENT OF A MINOR, RELEASE FROM LIABILITY, AND PHOTOGRAPH RELEASE I, the undersigned parent (legal guardian) of ___________________________________, a minor, understand that in the event medical treatment is required, every effort will be made to contact me. However, if I cannot be reached, I do hereby authorize Overlake Christian Church as an agent(s) for the undersigned to consent to an x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician or surgeon licensed under the provisions of the PHYSICIANS AND SURGEONS ACT and on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It’s understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority & power on the part of our aforesaid agent, to give specific consent to any and all such diagnosis, treatment or hospital care which aforesaid physician in the exercise of his best judgment may deem advisable. I further agree to indemnify and hold harmless Overlake Christian Church, their leaders, agents, sponsors, and any members from any liability or personal injury, loss, or damage that may be sought by any party for any reason whatsoever as a result of said minor(s) participation in the above named event. I have read the above and consent to my child participating in the event listed above. I also understand that my child is under the authority of the church leadership and that failure to comply with leadership could result in dismissing my child from this event and my being called to pick him/her up. I also hereby grant permission to Overlake Christian Church (Redmond, Washington) to use photographic images containing photograph/likeness of said minor for various purposes such as printed material, publications, displays, video productions, PowerPoint presentations, etc., as well as for the various Overlake-related sites on the World Wide Web (WWW). I also acknowledge Overlake’s right to crop or treat the photographic image at its discretion. I certify I have personal health insurance, including foreign countries, with no territorial limitation, for the providing of medical services to me which will provide coverage for me during the duration of said mission. I understand that Overlake Christian Church provides no health plan except the traveler’s short-term insurance.

______________________________________ Insurance Company

____________________________ Policy #

______________________________________ Insurance Company Phone Number __________________________________ Parent Signature

______________________________ Date

_________________________________ Print Name

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Tijuana 2017

Student’s Birthdate: _____________________ Gender: M / F Age: _____________ Is your son/daughter taking any prescribed medication or have any allergies? Yes / No If yes, please specify the medication and dosage or allergies:_______________ ________________________________________________________________ ________________________________________________________________ Is your son/daughter presently under a physician’s care for any illness? Yes / No If yes, please explain, ______________________________________________ ________________________________________________________________ Has your son/daughter ever had any serious health issues that need to be factored into his/her participation on this trip? Yes / No If yes, please explain, ______________________________________________ ________________________________________________________________ PARENT CONTACT INFO Parent Name ________________________ Phone # _________________________ Address ______________________________________________________________ City ________________________________ State __________ Zip ______________

ADDITIONAL EMERGENCY CONTACT Name ______________________________ Phone # _________________________ Address ______________________________________________________________ City ________________________________ State __________ Zip ______________

PLEASE SUBMIT ALL COMPLETED FORMS WITH A $100 DEPOSIT TO CONNOR TAKATA

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PARENTAL CONCENT FOR MINOR TO TRAVEL OUT OF COUNTRY I hereby grant permission to _________________________________, age______ (Name of Minor) who is my son/daughter and who was born in_________________________________ (Please circle one) (City, State) to make a tourist visit to Tijuana, Mexico and to go to Siempre Para Los Ninos, from the dates of May 26, 2017 to May 29, 2017 _________________________________ Print Name of Father

__________________________________ Print Name of Mother

______________________Date: ______ Signature of Father

_______________________ Date: ______ Signature of Mother

The following is to be filled in and signed by a notary public. State of: __________________________, County of: ___________________________, On this day personally appeared before me ___________________________________ to me known to be the individual(s) described in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the same as his/her/their free and voluntary act and deed, for the uses and purposes therein mentioned. GIVEN under my hand and official seal this _______day of _____________2017

______________________________________ (Signature) ______________________________________ (Print Name)

Notary stamp here Notary Public in and for the St of WA residing at: ____________________________________ My appointment expires on________________

Tijuana 2017