REGISTRATION FORM Name________________________________ Address_____________________________ City_____________________Zip__________ Phone #(s) ___________________________ DOB______________Grade_____________ Parent Email___________________________ PREFERRED T-SHIRT SIZE (Circle One) Adult Sizes:
S
M
L
XL
INSURANCE AND LIABILITY WAIVER In order for my child,_____________________________, to go on and participate in the trip to M-Fuge Louisville, I understand that I will be responsible for any medical expenses for myself and my dependent and waive any legal right or claim I or my family might have against Grace Evangelical Church, its staff, or Board of Directors as a result of any injury incurred or death by participation in activities or travel to or from Louisville, KY. __________________________________ Participant’s Parent or Guardian
_______________________ Date
EMERGENCY CONTACTS & PHONE NUMBERS 1.______________________________
________________
2.______________________________
________________
3.______________________________
________________
PREPARATION: 1. Attend training in evangelism/missions and a community service project 2. Scripture memorization 3. A short paper describing your testimony and why you want to attend MFuge COST: The total cost of the trip is $332. However, the junior high ministry donates $150 to each student, which brings the total down to $182. A non-refundable deposit of $50 is due when you turn in your registration form. Since this is a missions-based trip, we ask that you (not your parents) work to earn the remaining balance of $132. WHO CAN GO: Any student in 7th or 8th grade who is willing to meet the above requirements. You will need to turn in your essay when you sign up. There are only 25 spots available, so sign up soon! Eighth graders will have the first opportunity to register, and any remaining spots will be open to 7th graders. WHEN TO SIGN UP: January 21st - 9am: 8th grade registration begins January 28th– 9am: 7th grade registration begins You may sign up IN PERSON ONLY. Be sure to fill out this form and have your testimony written out and with you to sign up.
BE PRAYING! Mission trips are a great experience, but they are also hard work. Yes, we will have fun, but the primary purpose of this trip is much greater. Start praying now about possibly attending!
WHAT’S IT ALL ABOUT? M-Fuge is a trip that helps students put their faith into action. Students who attend M-Fuge are trained in sharing the love of Christ through evangelism and service to the community. They become equipped for leadership roles in student ministry. Check it out at www2.lifeway.com/fuge/
WHAT DO YOU DO THERE? Each morning begins with a time of worship and Bible study. Then each group travels to their local mission assignment, which could be any of the following:
Children’s Ministry/VBS Construction/Yard work/Painting Social Ministries Games and Recreation
In April, you will fill out a form with your top 3 ministry choices. Upon arrival, everyone is split into different groups according to their ministry assignment. This is a neat opportunity to build friendships with students from churches in surrounding areas. ANYTHING ELSE? Each evening there is a camp-wide worship and Bible study session, followed by a discussion with your group from Grace Evan. WHO’S THERE TO HELP? The M-Fuge staff consists of trained college and seminary students with a passion for ministry. This year, we will attend M-Fuge during the week of July 9-13th, hosted by Southern Seminary in Louisville, KY.
All the medical information on my child's registration form is complete and correct. I, the undersigned, hereby authorize the staff of Grace Evangelical Church to act as my agent to consent to medical, surgical, or dental examination and/or treatment. In case of emergency, I hereby authorize treatment and or care at any hospital. ________________________________ Participant’s Parent or Guardian
_______________________ Date
Grace Evangelical Church 9750 Wolf River Blvd. Germantown, TN 38139 901-756-7444 www.graceevan.org
[email protected] [email protected]
grace evan jr high
MEDICAL & EMERGENCY AUTHORIZATION
MEDICAL INFORMATION
JULY 9-13, 2018
Family Insurance Carrier__________________________ Policy #___________________________________________ _________________________________________________ Name of Policy Holder_______________________________ Important allergies/medical information____________ ___________________________________________________ ___________________________________________________ Medication taken during the trip __________________ ___________________________________________________
PARENTAL AGREEMENT
Emergency Contacts:
I agree that my child could possibly be sent home at my expense for bringing, using, or having any of the following items: alcohol, tobacco products, fireworks, or any weapons. I also give the staff and leaders permission to send my child home at my expense for any behavior they feel is disruptive and/or inappropriate.
Max’s cell: 901-590-5180 Madi’s cell: 901-517-6180
______________________________________________ Parent Signature
______________________________________________ Youth Signature
Louisville, KY
