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)
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