Summer 2023: Recovery Trip Application Form (must fill out for each participant)

Name

Address

This address will receive a confirmation email

Cell Phone

Home Phone

Date of Birth

Are you a member of BPC?

Yes No

If you are not a member of BPC, please let us know the name of your church and its denomination, if applicable.

Briefly tell us why you would like to participate in the BPC Mission Trip.

What are your expectations for this trip? What do you want to contribute and what do you expect to get from it?

Please provide three fun facts about yourself that you would like to share with the other trip participants ie. I lived in Montreal for 6 months during my junior year of college.

What is your usual occupation?

Your Skills

Please let us know your level of skill using this 1-4 scale:

1 - Can supervise or teach this activity

2 - Able to competently perform this activity

3 - Could perform this activity with sufficient instruction

4 - Have never done this, or not a skill of mine

Carpentry

1 2 3 4

Cement Work

1 2 3 4

Demolition

1 2 3 4

Drywall

1 2 3 4

Electrical

1 2 3 4

Floor/Tile

1 2 3 4

Glasswork

1 2 3 4

Masonry

1 2 3 4

Painting

1 2 3 4

Plumbing

1 2 3 4

Roofing

1 2 3 4

Yard Work

1 2 3 4

I would like to volunteer as a designated trip driver.

Yes No

Cost

The cost for the 2023 Summer Trip to Mission At The Eastward is $350 per person for the week and covers food (breakfast, lunch, dinner, snacks), lodging, and travel to and from the worksites. Sponsorships and payment plans are available. Since Mission Trip funds support our meetings, the trip itself, and financial assistance, we ask all participants to help with fundraising efforts, such as holding a bake sale, concert, or carwashes. It is our sincere hope that no one misses this opportunity to serve.

Prayerfully consider what portion of the cost you will contribute to those needing financial assistance. Then decide what percentage you will raise through ‘personal’ fundraising with family, friends, and co-workers. After you determine those amounts, request how much you will need to satisfy your costs for the trip. Use this form to complete this information. The number you enter in the two fields below should total $350.

Payments can be made by check to Bedford Presbyterian Church. Please write "MATE Mission Trip" on the memo line.

Amount of financial assistance requested:

Amount I am contributing:

Medical Information Form

Please click on the link below to print and complete the Mission Medical Information Form. For privacy purposes, this form cannot be completed online. The Medical Information form needs to be completed and returned to the church office: Bedford Presbyterian Church, Attention: Pastor John Sawyer, 4 Church Road, Bedford, NH 03110

DOWNLOAD MEDICAL INFORMATION FORM

RISKS & RELEASES

Medical Waiver and Release

In the event treatment is required from a physician and/or hospital personnel designated by the Church (or team leaders), I/we agree to hold such person/s and BPC free and harmless of any claims, demands, or suits for damages or injuries arising from the giving of such consent. The volunteer (and parent) releases and forever discharges BPC, team leaders, trip participants from all and any claims that may arise due to first aid or decisions regarding medical care.

Agree?

Risks and Release

I/we understand that there are inherent risks involved in any mission event and that I am volunteering for an event that includes the repair of damaged and/or potentially unsafe buildings. I/we understand that BPC and its partners do not guarantee my safety nor do they claim responsibility for my safety or personal belongings. I/we hereby assume all risks related to the injury, illness, loss or harm that may occur to me/my child during or after the duration of the event. I/we release and hold harmless BPC, its pastors, employees, volunteer workers and its partners in this mission event from any and all liabilities for injury, illness, death or loss/damage of property that may occur during the course of my own or my child’s involvement, including all travel during the event.

Agree?

Photo Release

BPC takes and uses photos for its newsletter, brochures, presentations, event announcements, social media, and/or website.

Do you give permission for photos and/or videos to be used for church purposes?

Safe Haven Policy

Please click to view the Safe Haven Policy.

I, the participant, have read and agree to the BPC Save Haven Policy.

Church Mission Team Covenant

Please click to view the Church Mission Team Covenant.

I, the participant, have read and agree to the BPC Mission Team Covenant

Conduct

I agree to participate fully in the worksite projects, group activities, and other responsibilities that may be assigned. I understand I am responsible for my own actions and I agree to follow all federal, state, and local laws as well as the BPC Covenant of Conduct and Safe Haven. Further, I understand that I am a representative of BPC and of our Christian community. If I fail to abide by the law or policies in the BPC Covenant, I/we understand that I could be sent home immediately at my own or my family’s expense.

Agree?

Confirmation Signature

Please type your full name in the space provided.

Date

Parental Consent (required for volunteers under 18 years of age)

I hereby give permission for my child to participate in the Housing Ministry project coordinated by MATE on the following date(s): July 30 to August 4, 2023.

I understand that I am responsible for his/her medical insurance and will not hold MATE or BPC liable for any injury or damage to my minor child while engaged in the project.

Parent/Guardian Signature (Please type your full name in the space provided)

Date

Summer 2023: Recovery Trip Application Form (must fill out for each participant)

Description

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