Registration Form

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Touching Lives. Reaching Generations.

Middle School Mission Trip June 25-29, 2018

$115 ~ Early Bird Registration ~ MUST BE PAID IN FULL by May 9, 2018 $125 ~ Regular Registration ~ Closes on June 13, 2018 $140 ~ Late Registration ~ Closes on June 20, 2018 $50 deposit & completed forms locks in your rate (excluding early bird) and spot All balances due on June 20, 2018

PLEASE PRINT CLEARLY ___________________________________ Student Name

________

___________

Grade

Gender (M/F)

________________________________________________ Address

______________________

City/State

Zip

Date of Birth

_____________ Adult T-Shirt Size

______________________ _____________________________

Student Cell #

Home Phone

___________________________ Parent Name

___________________________ Parent Name

________

___/____/____

Student E-Mail

_________________

__________________________

Cell #

E-mail

_________________

__________________________

Cell #

E-mail

Return registration form, medical form, and Arms of Hope Waiver form with a $50 Deposit (non-refundable) no later than June 20, 2018. LIMITED SPACE! - register EARLY! For more information call 830-625-0267

0AKWOOD BAPTIST CHURCH STUDENT MEDICAL FORM NAME:________________________________________________________________________________ (LAST) (FIRST) (MIDDLE) PARENT'S NAME:_______________________________________________________________________ (FOR THOSE UNDER 18) ADDRESS:_____________________________________________________ ZIP: ___________________ PHONE:_______________________ ALT. EMERGENCY CONTACT #:___________________________

List below any physical defects or conditions you have, such as allergies, nervousness, headaches, dysmenorrheal, etc._______________________________________________________________ _______________________________________________________________________________ Should you at any time during the trip require medical attention, list any special instructions which you might require, such as being allergic to penicillin, having a rare blood type, etc.____________________________________________________________________________ _______________________________________________________________________________ FOOD ALLERGIES / RESTRICTIONS: ________________________________________________ _______________________________________________________________________________

CURRENT IMMUNIZATION STATUS:

Tetanus_________________

Polio_________________

MEDICAL INSURANCE: Company Name & Policy Number

____________________________________________________________________ ____________________________________________________________________ Permission for Medical Treatment

To Be Filled Out By Parents or Guardians of Young People Under 18 Years I, ____________________________________________, the parent and/or guardian of _______________________ _____________________________, a minor, hereby acknowledge that said minor is presently under my care, custody, and control. I hereby give my child, the said minor, my express permission to go on any trips sponsored by Oakwood Student Ministry while they are an active participant in this ministry. I further expressly grant my permission for my child to participate in all activities while on the trip. In the event there arises an emergency, necessitating medical or surgical attention, I hereby consent and give my permission to Oakwood Baptist Church, its representatives, or the sponsors, or any attending physician, to make such decisions and to perform such medical treatments and/or surgery upon said minor which may, in their sole discretion, be necessary and proper under the circumstances. I, the undersigned parent and/or guardian of ________________________________________, a minor, do release, acquit, discharge, and covenant to harmless Oakwood Baptist Church or its representatives, or the sponsors, or any attending physician, from any and all actions, causes of actions, damages or liabilities arising out of the treatment of any sickness or accident, and from any financial responsibility for all medical treatment provided during the attendance of any/all trips. __________________________________________ SIGNATURE

Photograph/Video Notice

I understand that as a participant in the Oakwood Student Ministry, my child may be photographed or videotaped during normal activities and these photos/videos may be used in promotional materials for OSM (i.e. Website, posters, flyers).

DATE ________________

__________________________________________ SIGNATURE

Waiver of Liability and Release Please read the following carefully. If you have any questions, have them answered before signing this document. In consideration of being allowed to participate as a volunteer during the __________________________(event), I hereby release, waive and hold harmless Arms of Hope which encompasses Boles Children's Home, Medina Children’s Home, their Boards of Directors, officers, agents, and employees from and against any and all claims, demands or causes of action of any type whatsoever, including property damage, personal injury or death, arising out of or in any way related to my participation in this event for which I have volunteered. During this event, there may be opportunity to participate in activities on the Adventure Learning Activity (R.O.P.E.S.) course, courts, gym, and at the swimming facility. This Waiver of Liability and Release also applies to these activities. I am aware that there are risks and dangers associated with my participation in community service projects, including the risk of property damage, personal injury or death. I acknowledge that my participation in this event at an Arms of Hope campus is voluntary and that I assume full responsibility for any injuries or damages I may sustain as a result of my participation, including while traveling to or from a service project. I agree to use all appropriate precautions and follow safety practices while on an Arms of Hope campus.

I understand that I am solely responsible for any medical costs I may incur as a result of my participation in this event at Arms of Hope. By signing this Waiver of Liability and Release, I acknowledge that I have read this document, I fully understand it, and agree to its terms and conditions. The undersigned participant in this service activity also agrees to the terms and expectations of this agreement including Arms of Hope use of photographs and/or video that contains their image for publication purposes including; marketing, fundraising and/or informational presentations:

Print Name: __________________________________________________________ Date: _______________ Signature:__________________________________________________________ Phone #: ______________

Address: _________________________________________City:_____________State:________ZIP:_______ Email Address _____________________________________________________________________________ Family members who are also "Friends of Arms of Hope" and your relationship: Example: Jon Doe - brother _________________________________________________________________________________________ For persons under 18 years of age – please complete. This person will be contacted in case of an emergency. Print Name: __________________________________________________________ Date: _______________ Name of Guardian/Parent:___________________________________________________________________ Signature of Guardian/Parent:___________________________________________ Phone #:_____________ Complete Address: _________________________________________________________________________ Email Address _____________________________________________________________________________

Witness: Signature: ____________________________________________________________ Date: ______________ Print name: ________________________________________________________ Phone #: ______________

Keep this page for your records WHAT TO BRING What can I pack for the bus ride? You may take ONE small to medium sized carry-on onto the bus. Snacks and drinks are fine. NO personal DVD players or other video playing devices. The bus will have DVD’s and TV monitors, so you may bring some GOOD movies if you want. The movies need to be G or PG rating. Cards and other travel games are a good idea, too. How much extra money do I need? You shouldn’t need any extra money. All meals are provided. What clothes should I bring/DRESS CODE • Modest is hottest. For free time & kid connect time please bring modest shorts & shirts. NO bikinis or speedos if water sports occur. Tankinis are acceptable.  Do not dress in a way that calls attention to their underwear (sagging pants, rolling down your waistbands, etc)  Long sleeved shirts are recommended for service projects 

For your safety, jeans & tennis shoes/boots MUST be worn for service projects. Sandals & shorts are not appropriate for these projects & can be deadly!

What about girl stuff? Please bring the necessary “girly” stuff you may need to get you through a week of camp. We will have an assortment of “girly” stuff on the trip should you run into any problems. If you need any supplies while on this trip please ask a female leader for assistance. Bedding & Toiletries Bring all your own linens and bedding for a twin bed. All toiletries are provided at the facility but you can bring your own if you wish. First Aid & Safety Items • DO NOT FORGET sunscreen & insect repellant!!! • Make sure to bring a LABELED refillable water bottle.  Also Bring work gloves & a hat for service projects  Basic first aid equipment will be available such as Tylenol, Ibuprofen, band aids, antibacterial ointment, etc.  If you must take prescription medication while on the trip please inform a leader at check-in.  If you have an EpiPen allergy please make sure the leaders are aware prior to going on the trip.

ARMS OF HOPE RULES BUILDING RULES - Be inside Hospitality room by 10 p.m. The doors are locked at that time. This is a campus-wide curfew. Girls should not be in boys’ rooms and boys should not be in girls’ rooms. Do not run in the halls. FOOD – Breakfast is provided in the Hospitality café. Snacks are available anytime – help yourself. Lunch will be @ the gym. Supper will be provided at the cottages, gym or other locations. Please do not take drinks & snacks to your rooms or entry foyer (water is ok). Snacks & drinks will be available in Hospitality room during break time. LAUNDRY – Please place your wet towels & linens in the baskets in the hall. They will be washed and returned.

SAFETY – Be aware of your surroundings. This is the country. Watch for wild animals, snakes, spiders and scorpions. Safety glasses, gloves & ear plugs are available at the shop for service projects. HIPPA - DO NOT ask the kids direct, personal questions because this is against Privacy Laws and AOH policy. Don’t share cell phone or i-pods w/ our kids.

WHAT NOT TO BRING •

• • •

Arms of hope provides towels, washcloths, soap, shampoo, conditioner, toothpaste, etc. Bring your own if you want to... Do not bring your electronic devices such as iPods, iPads, DVD/Blu-ray players, etc. Do not bring drugs, alcohol, or tobacco—DUH! NO water guns, water balloons, or weapons, etc.

Middle School Mission Trip June 25-29, 2018 TRIP INFO Contacts During the Trip Pastor Brandon: (830)832-1262 Tory Tierney: (210)854-2307 Arms of Hope Address Medina Children’s Home 21300 St. Hwy. 16 N. Medina, TX 78055

IMPORTANT DATES June 14 @ 12-2pm ~ Student Training in the Pavilion June 21 @ 12-2pm ~ Student Training in the Pavilion June 24 @ Noon ~ Parent & Student Meeting in the Pavilion June 25 @ 10:30am ~ Meet @ Oakwood Pavilion June 29 @ 3:00pm ~ Arrive @ Oakwood Pavilion

DO NOT FORGET Sunscreen Bug Spray

Jeans you do not mind ruining Close-toed shoes for service projects Refillable water bottle Bedding for twin bed