YWAM Nashville Registration
www.ywamnashville.org
Office - 800.454.7753
Fax - 615.696.2419
We are excited that you are considering taking an outreach with us! We
have opportunities this year during the spring and summer break (JuneAugust) in Memphis, Nashville, or Cancun, Mexico. A typical trip is broken
up into two sections: training and outreach.
Training
We have teachings, worship, prayer times for you and for the outreach. Our
training prepares you for the outreach and comes out of our YWAM values that
you can become more familiar with here: http://www.ywam.org/About-YWAM/
Who-we-are/The-Foundational-Values-of-Youth-With-A-Mission I have given a
couple of examples of the topics we typically teach on to get you equipped for the
outreach part of your trip:
-The Great Commission: Evangelism & Discipleship Mt 28:18-20, Mk. 16:15
-Hearing God's Voice as a believer- John 10:27
-Prayer and Intercession
and more...
Outreach
The outreaches can be geared towards what you want your group to do and what
your specific giftings are as a group. We can work with you and try to do the
things that your group wants to do, however, sometimes it doesn't work out
completely like we would like it to due to the schedules of the other ministries that
we work with. Some of the ministries that we have done in the past are:
-Refugee Ministry
-Homeless Ministry
-Street Evangelism
-Prayer walks
-Youth inner-city ministry
-minor construction and/or work projects
We can try to do all of those things to give the group a rounded experience or if
something interests you more than others we can try to set up multiple days with
the same ministry but as was mentioned before, sometimes it doesn't work out
depending on the partnering ministries schedule. Please note that refugee
ministry is only available in Nashville and youth inner-city ministry in available in
Memphis.
The cost is $52 a night per person and that includes food, housing,
administration of the outreach, host staff, and training. There is also a $25
deposit fee per person that goes towards the overall costs.
The dates and timeframe are totally dependent on your group. You can stay for
up to 10 nights and typically at least 2 nights is good so that you can get the full
experience but we have had teams come for a day only and it worked just fine.
Just give us a date and a timeframe and we will make sure that it works (more
than likely it will) with us. If you need information please contact us @
615-696-3096 and ask for the Short-term Outreach coordinator.
Thank You very much for partnering with us. We are excited to see God advance
His Kingdom in and through you!
YWAM Nashville
Mail direct payments and correspondence to
YWAM Short-Term Outreach
P.O. Box 78219
Nashville, TN, 37207
Make all checks payable to YWAM Nashville
Lump sum payments must be submitted by the church or group leader. We cannot accept
individual checks for or from individual group members.
Important Financial & Deadline Information
How
Much
Important
Dates
NonRefundable
Deposit Fee
& Form 1 &
2
$25 per
person
6 weeks prior
to your arrival
date
*
Balance
&
Form 3 & 4
Specific to
outreach
4 weeks prior
to your arrival
date
Forms
Transferable
Refundable
*
How to add or subtract people from your group.
• If your group increases or decreases in size, please notify us immediately.
• Any additions to your group must be approved by our office, on a space-available
basis.
• Remember, if you subtract people from your group, the deposit fee is still nonrefundable, but can be transferred to your group’s total cost.
Group
Registration - Form 1
Please fill out this form completely.
• Do not forget to check off which outreach you are applying for to the right.
• Use one registration form per outreach. (Make copies if necessary.)
• Do not forget to include the $25 per person deposit fee.
• We must receive the deposit fee in order to reserve your spot.
Group Name: _______________________________________________________
Group Leader’s Name: ________________________________________________
Church Name: _______________________________________________________
Denomination: _______________________________________________________
Church Address: _____________________________________________
City: ________________________State/Prov: _________________ Zip: __________
Phone: ______________________ Fax: ___________________________________
Group Leader’s Home and Cell Phone: ____________________________________
Emergency Phone Number: _____________________________________________
(For use while group is on outreach)
What is the expected size of your group? __________________________________
*There is a $25.00 per person deposit fee which goes towards the total
price.
Total registration fee enclosed:
Group Registration - Form 1
Please check the box of your desired trip and send in this page with
the group registration form. Also please note that airfare and US
transportation is NOT included in price.
Spring Break & Summer
Outreaches
The cost is $52 per night. The cost includes
housing, administration of the outreach,
food, training, and any overhead. You can
come for as many nights as you would like
during the spring or the summer seasons,
but please communicate when you are
coming to our short-term outreach
department.
USA Choose your Location !
Nashville, TN
Memphis, Tn
Mexico Confirm your Location
Cancun, Mexico
Group List - Form 2
Please fill out this form completely and return it to us.
Group Name:_________________________________________________________
Group Leader: ________________________________________________________
Outreach Destination: __________________________________________________
Outreach Dates: _______________________________________________________
On the following lines, please list the names of all the participants, their age and sex.
(Please print)
Gender Age
1. Name: _____________________________________________ M F
_____
2. Name: _____________________________________________ M F
_____
3. Name: _____________________________________________ M F
_____
4. Name: _____________________________________________ M F
_____
5. Name: _____________________________________________ M F
_____
6. Name: _____________________________________________ M F
_____
7. Name: _____________________________________________ M F
_____
8. Name: _____________________________________________ M F
_____
9. Name: _____________________________________________ M F
_____
10. Name: ____________________________________________ M F
_____
11. Name: ____________________________________________ M F
_____
12. Name: ____________________________________________ M F
_____
13. Name: ____________________________________________ M F
_____
14. Name: ____________________________________________ M F
_____
15. Name: ____________________________________________ M F
_____
16. Name: ____________________________________________ M F
_____
17. Name: ____________________________________________ M F
_____
18. Name: ____________________________________________ M F
_____
19. Name: ____________________________________________ M F
_____
20. Name: ____________________________________________ M F
_____
Group List - Form 2 Continued
Gender
Age
21. Name: ____________________________________________ M F
_____
22. Name: ____________________________________________ M F
_____
23. Name: ____________________________________________ M F
_____
24. Name: ____________________________________________ M F
_____
25. Name: ____________________________________________ M F
_____
26. Name: ____________________________________________ M F
_____
27. Name: ____________________________________________ M F
_____
28. Name: ____________________________________________ M F
_____
29. Name: ____________________________________________ M F
_____
30. Name: ____________________________________________ M F
_____
31. Name: ____________________________________________ M F
_____
32. Name: ____________________________________________ M F
_____
33. Name: ____________________________________________ M F
_____
34. Name: ____________________________________________ M F
_____
35. Name: ____________________________________________ M F
_____
36. Name: ____________________________________________ M F
_____
37. Name: ____________________________________________ M F
_____
38. Name: ____________________________________________ M F
_____
39. Name: ____________________________________________ M F
_____
40. Name: ____________________________________________ M F
_____
Does your group have any food allergies or special food needs that we need to
know about? ____________________________________________________
Please Remember:
If your group increases or decreases in size you must clear any
changes in advance through our office.
Group Arrival Information - Form 3
Contact Information
Group Name: __________________________________________________________________
Leader's Name: ________________________________________________________________
Outreach Destination: ___________________________________________________________
Outreach Dates: _______________________________________________________________
Emergency Contact Person: ______________________________________________________
Phone: _______________________________________________________________________
Arrival Information
Form of Arrival: _____ Airplane ______ Public Bus ______ Private Vehicles
Date of Arrival: _________________________________________________________________
Time of Arrival: _________________________________________________________________
City/Airport: ____________________________________________________________________
Name of Carrier: ________________________ Flight # ________________________________
Arrival Time: ____________________________________________________________________
Connecting flight information: ______________________________________________________
Departure Information
Date of Departure: _______________________________________________________________
Time of Departure: _______________________________________________________________
City/Airport: _____________________________________________________________________
Name of Carrier: ________________________ Flight # _________________________________
Arrival Time: ____________________________________________________________________
Connecting flight information: ______________________________________________________
Authorization Form (Minor: Under 18)
General Information
Name: _____________________________________________________________________________________
Address: _____________________________City: _______________ State/Prov.: __________ Zip: _____________
Day Phone: _____________________Evening Phone: _______________________Emergency Phone: ____________
Location: ___________________________________Dates: ____________________ to:_______________________
Medical Information
Name of medical insurance provider:________________________________________________________________
*Please supply a copy of the medical insurance card, both front and back.
Is your child allergic to any medication? (check one) Yes No If yes, please describe here:
____________________________________
Is your child taking any medication? (check one) Yes No If yes, please describe here:
_______________________________________________
Date of last tetanus inoculation: ___________________________________________________________________
Has basic childhood series of three tetanus shots been given? (check one) Yes No
Waiver and Release of Liability
In consideration of Youth With A Mission Nashville Inc. (YWAM) organizing, arranging and permitting me to attend
and participate in the event, I hereby waive all rights which I may now have or which may accrue in the future
against YWAM, its respective chapters, directors, officers, employees, and members (collectively the “YWAM
Representatives”), and I hereby release and discharge YWAM and the YWAM Representatives from, and agree to
indemnify and hold YWAM and the YWAM Representatives harmless from and against all liability for any and all
actions, damages, causes of action, suits, costs, losses, expenses, claims, demands, damages and judgements
(collectively the "Losses and Claims"), which I, my spouse, family members, children, invitees, heirs, executors,
administrators, successors and assignees ever had, now have or hereafter can, shall or may have resulting from or
arising in connection with my travel to, attendance at or participation in YWAM events.
I acknowledge that certain legal rights against YWAM or the YWAM Representatives may be available to me now or in
the future as a result of any Losses and Claims, and that by executing this waiver and release of liability, my spouse
and I are forever relinquishing those rights against YWAM or the YWAM Representatives. I acknowledge that no
promises, representation, or affirmations of fact were made to me by YWAM or YWAM Representatives concerning
the safety of the event, the security precautions taken in sponsoring the event, the relative safety or danger
associated with traveling to the event or participation in any activity, academy, event or outing related to, associated
with or connected in any way to the event and affirm that I have read and understand the foregoing provisions of
this waiver and release of liability and accept the terms of this waiver and release of liability as a condition to my
attendance at the event.
Authorization and Consent for Treatment
I give permission for my son/daughter to attend the above YWAM function. I have read the above waiver and
release of liability and agree to its provision. In addition, I give permission for my son/daughter to receive any
medical treatment deemed necessary by a physician.
Signature:_________________________________________________________Date: _______________
Relationship to Minor:____________________________________________________________________________
Authorization Form
(Adult: over age 18)
General Information
Name:_______________________________________________________________________________________
Address:___________________________City:________________________State _______________
Prov:_____________Zip:__________
Day Phone:__________________Evening phone:_____________________Emergency Phone:___________________
Location:_______________________________________Dates:_____________________to:__________________
Medical Information
Name of medical insurance provider:_________________________________________________________________
*Please supply a copy of the medical insurance card, both front and back.
Are you allergic to any medication? (check one) Yes No If yes, please describe here: _______________________
Are you taking any medication? (check one) Yes No If yes, please describe here: _________________________
Date of last tetanus inoculation: ___________________________________________________________________
Has basic childhood series of three tetanus shots been given? (check one) Yes No
Waiver and Release of Liability
In consideration of Youth With A Mission Nashville Inc. (YWAM) organizing, arranging and permitting me to attend
and participate in the event, I hereby waive all rights which I may now have or which may accrue in the future
against YWAM, its respective chapters, directors, officers, employees, and members (collectively the “YWAM
Representatives”), and I hereby release and discharge YWAM and the YWAM Representatives from, and agree to
indemnify and hold YWAM and the YWAM Representatives harmless from and against all liability for any and all
actions, damages, causes of action, suits, costs, losses, expenses, claims, demands, damages and judgements
(collectively the "Losses and Claims"), which I, my spouse, family members, children, invitees, heirs, executors,
administrators, successors and assignees ever had, now have or hereafter can, shall or may have resulting from or
arising in connection with my travel to, attendance at or participation in YWAM events.
I acknowledge that certain legal rights against YWAM or the YWAM Representatives may be available to me now or in
the future as a result of any Losses and Claims, and that by executing this waiver and release of liability, my spouse
and I are forever relinquishing those rights against YWAM or the YWAM Representatives. I acknowledge that no
promises, representation, or affirmations of fact were made to me by YWAM or YWAM Representatives concerning
the safety of the event, the security precautions taken in sponsoring the event, the relative safety or danger
associated with traveling to the event or participation in any activity, academy, event or outing related to, associated
with or connected in any way to the event and affirm that I have read and understand the foregoing provisions of
this waiver and release of liability and accept the terms of this waiver and release of liability as a condition to my
attendance at the event.
Authorization and Consent for Treatment
I have read the above Waiver and Release of Liability and agree to its provisions.
Signature:_______________________________________________________Date: _______________________
Consent To Travel - Form 4
(for ages 17 and under)
THIS FORM IS REQUIRED FOR ALL MINORS TO TRAVEL INTERNATIONALLY AND MUST BE SIGNED IN
THE PRESENCE OF A NOTARY TO BE VALID. THERE ARE NO EXCEPTIONS.
If you have questions, it is best to call your airline well ahead of time for specific information.
In order for a minor to travel internationally, this form must be completed in its entirety at least 30 days before the
date of travel. If this form is not properly completed, the individual below will not be able to travel internationally.
This is strictly enforced.
This form must be signed by both parents or both guardians. This includes separated or divorced parents, in which
case the participant will also need a notarized copy of the custody papers. If a parent is deceased, a certified copy of
that parent’s death certificate will be needed. In the case of legal guardianship with other than natural parents, the
legal guardians must sign and also provide certified copies of the guardianship decree. These are federal regulations
and are for your protection.
This form is to inform and assure international authorities that the group leader is not taking minors out of the United
States without parental consent. The participant should take this form to the airport and have it available with his/her
passport.
I, ___________________________ and ___________________________
(1st Guardian's name)
(2nd Guardian's name)
give permission for __________________ , a minor, to travel with Youth With A Mission and
under the supervision of its appointed leaders for the dates of ________________ in
connection with _________________________________ .
(outreach or destination)
____________________________________________________________________________
(signature of parent or guardian)
(signature of parent or guardian)
______________________________________________________________________
(date)
(date)
_________________________________
(Signature of Notary Public)
________________________________
(date)