2018 Registration Packet - absc. · PDF file... Block Party, Evangelism, Sports Ministry, Prayerwalking, Cleaning/Yardwork, ... Schedule . Friday – 6:30 ... Evangelism Training and

2018 Registration Packet

We are excited that you will be joining us for CONNECT this year! Please see the steps below on how to register your group.

If you have any questions, contact Travis ([email protected]) or call 501-376-4791, ext. 5137.

1. Complete the Group Registration Form.

2. Mail in the Group Registration Form with payment.

3. Complete and return the Group Names Form (You can type your responses directly into this form.) Due: Friday, March 30th

4. Hand out Student and Adult Registration and Release forms to your participants.

5. Collect Student and Adult Registration and Release forms and bring them with you to CONNECT on April 13th.

GROUP REGISTRATION FORM Registration is non-refundable however is transferable to another participant.

Please Print

Church Name:

Contact Person:

Address:

City: State: Zip Code:

Phone: Email:

Registration: # of Students _________

# of Adults _________

Total _________ X $25.00 = $ __________ amount Enclosed

Vehicle/Capacity (15 person van/25 person bus/etc.) _______________________________________________

Who will be the driver(s) for your group? ________________________________________________________

Will you be staying for Sunday worship? __________________________

Please complete this form and mail with your payment to:

Missions Team | 10 Remington Dr. | Little Rock, AR 72204

For more information, contact:

Travis at ([email protected]) || 501-376-4791, ext. 5137

A ministry of the Cooperative Program and

the Dixie Jackson Arkansas Missions Offering.

Student Registration and Release Please have each parent fill out, sign, and return this form for their student.

Name: _________________________________________________________________

Church: ________________________________________City:_____________________

Age:__________ Grade:___________ Date of Birth: ____________________

Address: ________________________________City, State, Zip: ____________________

Student Agreement:

I hereby consent to participation by ____________________________ my son/daughter/individual under my guardianship, in CONNECT 2018. I understand that my child will be under the supervision of the designated staff and/or volunteers at this event. I understand that such an undertaking involves an element of risk. I assume all risks and hazards incidental to such participation and do hereby release, absolve, indemnify, and agree to hold harmless ________________________________ (henceforth referred to as “the Church”), its staff, deacons, chaperones, volunteers, membership, and drivers from any and all liability that may arise out of participation in this activity. I also give consent for emergency medical treatment if necessary, as determined by the chaperones of the Church. I also agree to hold harmless and release the Arkansas Baptist State Convention (henceforth referred to as “the Convention”), other participating churches, and the Church, to include their staff, deacons, chaperones, volunteers, membership, and drivers from any and all liability related to expenses arising from the giving of such medical care to the extent those expenses are not reimbursed by me or my child’s health insurance provider(s). As parent/legal guardian, I remain fully liable for any legal responsibility which may result from any personal actions taken by the named participant.

I hereby grant permission to the Church and Convention to use my child’s/individual’s under my guardianship likeness on its promotional materials including, but not limited to videos, web sites, and printed materials without further consideration, and I acknowledge the Convention and Church's right to crop or treat the likeness at its discretion.

Parent/Guardian Signature: ________________________________ Date:____________

Insurance Company:_______________________________ Policy #:_________________

Physician: ____________________________________ Phone #:____________________

Date of Last Tetanus Shot: _____________________________

In Case of Emergency Notify: ________________________________

Phone #:_________________________________

In Case of Emergency Notify: _________________________________

Phone #:_________________________________

Church’s

Name

Student’s name

Adult Registration and Release Please have each adult fill out, sign, and return this form.

Name: _________________________________________________________________

Church: ________________________________________City:_____________________

Age:__________ Date of Birth: ____________________

Address: ________________________________City, State, Zip: ____________________

Chaperone Agreement:

I, ________________________________, assume all risks and hazards incidental to such participation and do hereby release, absolve, indemnify, and agree to hold harmless __________________________ (henceforth referred to as “the Church”), its staff, deacons, chaperones, volunteers, membership, and drivers from any and all liability that may arise out of participation in this activity. I also give consent for emergency medical treatment if necessary, as determined by the chaperones of the Church. I also agree to hold harmless and release the Arkansas Baptist State Convention (henceforth referred to as “the Convention”), other participating churches, and the Church, to include their staff, deacons, chaperones, volunteers, membership, and drivers from any and all liability related to expenses arising from the giving of such medical care to the extent those expenses are not reimbursed by my health insurance provider(s). I remain fully liable for any legal responsibility which may result from any personal actions taken by the named participant.

I hereby grant permission to the Church and Convention to use my likeness on its promotional materials including, but not limited to videos, web sites, and printed materials without further consideration, and I acknowledge the Convention and Church's right to crop or treat the likeness at its discretion.

Signed: _____________________________________________ Date: _______________

Insurance Company:_______________________________ Policy #:_________________

Physician: ____________________________________ Phone #:____________________

Date of Last Tetanus Shot: _____________________________

In Case of Emergency Notify: ________________________________

Phone #:_________________________________

In Case of Emergency Notify: _________________________________

Phone #:_________________________________

Chaperone’s name Church’s

Name

Group Names FormPlease submit your participants’ names and information by March 30th.

E-mail to Travis: [email protected]

Fax to Missions Team: 501-376-7463

Church Name/City: ___________________________________________________

Group Leader: _______________________________________________________

E-mail Address: ______________________ Phone Number: __________________

Name Adult/Student Male/Female 1st Choice* 2nd Choice*

* If your participants prefer a certain type of work project, please indicate in the last two columns. *Project choices: Light Construction, Painting, Block Party, Evangelism, Sports Ministry, Prayerwalking,

Cleaning/Yardwork, Surveying Neighborhoods, Backyard Bible Club, Senior Adult Ministry

Schedule Friday – 6:30 – Registration 7:30 – Connect with groups and Leader’s Meeting 8:00 – Making the Connection (Worship) 9:30 – Connect with your Team 10:00 – Free Time and Concessions

Saturday 6:00 – Wake Up/Devotion 7:00 – Breakfast 7:30 – Evangelism Training and Prayer Time 8:00 – Connect with Community (leave for worksites) 6:00 – Dinner 7:15 – Connect with your Ministry Team (debriefing) 7:45 – Making the Connection (Worship) 9:00 – Church Debriefing

Free Time

Sunday 7:30 – Breakfast

Clean up Connect with Local Church (beginning times will vary) Lunch with Local Church Connect with your Community (head home)

What to Bring Work clothes for Saturday

Tennis shoes (no open-toed shoes at worksites)

Change of clothes for Saturday night/Sunday morning

Sleeping bag or sheets/blanket

Air Mattresses/pump (All lodging is in a local church which will include sleeping on the floor.)

Pillow

Toiletries (shampoo, soap, deodorant, toothbrush, toothpaste etc.)

Towel/washcloth

Bible

Pen/paper

Money for snacks (CONNECT T-shirts will also be available for $10/$15)

Earplugs (if you’re worried that you might not get any sleep because of all of the snoring)

Your group will also receive a list of supplies to bring specific to the jobs that your

participants will doing. You will receive this list by the week of the event.

What NOT to bring: Bad attitudes

No weapons of any kind (guns, knives etc.)

No silly string, shaving cream, or anything used to play practical jokes

No fireworks

No drugs, cigarettes, alcohol etc.

No shirts with inappropriate messages, pictures etc.

Leave expensive jewelry and other items at home (these are unnecessary and might get

lost/broken and/or stolen).

IPods, MP3 players etc.

We are not responsible for any lost/damaged or stolen items. Cell phone usage is discouraged

during worship, ministry, and any group activities except in the case of an emergency.