2023 ASP Registration

Registration

Registration Options

Pay Deposit ($175.00)
Pay in Full ($350.00)
Balance due of $175 ($175.00)
Scholarship of $175 for Deposit ($0.00)
Full Scholarship of $350 ($0.00)
Discounted registration (after 6/1/23) ($225.00)

Youth Information

Youth Name

Youth Email

Youth Cell Phone Number

Youth Home Phone Number

Address

Current Grade

Date of Birth

List other relatives of participants on the trip

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Cell Phone Number

Parent/Guardian Home Phone Number

Parent/Guardian Work Phone Number

Parent/Guardian Email Address

Parent/Guardian 2 Name

Parent/Guardian 2 Cell Phone Number

Parent/Guardian 2 Home Phone Number

Parent/Guardian 2 Work Phone Number

Parent/Guardian 2 Email Address

Emergency Contact

Name

Is this person on the trip?

Address

Phone Number

Relation to Participant

Terms

I understand that my participation in this trip includes:

* Participating in all group fundraising efforts, including the ASP Dinner and Silent Auction.
* Attending all four trainings for the ASP trip. (2 of 4 may be attended virtually if necessary).
* Agreeing to abide by the Covenant.
* Participating in the life of this church community by attending classes, worship, and youth fellowship.

I have read and agree to the terms above.

Covenant Form

Our youth groups are an important part of the church community. Since we are committed in youth fellowship to be ambassadors of our church, we agree to act at all times as responsible representatives of this community. We will do this by:

* Showing respect to our peers and adult leaders by our words and actions.
* Being respectful of those we will be serving.
* Being good stewards of vehicles and materials used on the trip.
* Never using aggressive physical behavior.
* Observing the youth group rules of:
* No alcohol or illegal drugs to be used or in possession at any time.
* No aerosol cans or weapons (knives, etc.)
* No physical intimacy with other members of the group or exclusive behavior toward any persons.
* Participation in training and fund-raising for the trip.
* Willingness to grow as part of this community.
* I understand that if I cannot live with these rules and expectations, I will be sent home at my parent's expense.

I have read and agree to the terms above.

Parent's Consent

I understand and agree that my youth's participation in the mission trip depends on observing the covenant and that he/she/they will become ineligible to participate before or during the trip by failing to observe the covenant. I understand that the cost of returning before the group will be my responsibility.

I have read and agree to the terms above.

Youth Ministry Medical Waiver

If you have not already completed the 2022-2023 Youth Registration Form, please do so here. This will allow us to take your youth on the road!

Additionally, each youth is required to complete the 2022-2023 Master Medical Form and Waiver. Email it to [email protected]. This form is required to participate.

Not sure if you've already completed these forms and submitted a current medical insurance card? Contact Krys Juleen at [email protected] to confirm.

Running Total

$0.00

Total

$0.00

2023

High School Mission Trip

Registration

Youth Information

Parent/Guardian Information

Emergency Contact

Youth Ministry Medical Waiver

Billing Information