6. For safety and security youth may not leave the area where we are staying without an adult leader.

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1 Expectations and rules for CUMC Youth Mission Trip to Shiprock 2013 CUMC Youth Mission Trips are all about creating community-- between all the participants and sharing Christ s love in the community with the people we serve. Living in a different community means sometimes we can t do what we d like to do and sometimes we must do what we don t like to do. These guidelines help us support one another so all participants can focus more on God and service and less on our individual needs. 1. The chaperones have overall responsibility for all activities while on the trip. Please show respect and cooperate with their directions and requests. 2. Adult chaperones are responsible at all times for the safety of the youth under their care. All youth are responsible for looking out for all group members to ensure everyone s safety and inclusion. 3. Everyone, youth and adults alike, are expected to participate in all activities. Everyone will be assigned to help cook meals and keep the kitchen, living areas and vehicles clean. 4. We will have zero tolerance for any negative behavior toward other group members. This includes excluding anyone from group relationships, sexual harassment, abusive language or behavior, or discrimination of any type. 5. Males and females will sleep in separate areas and are not allowed in each other s sleeping areas. No activity is allowed after lights out to ensure adequate rest for all participants. 6. For safety and security youth may not leave the area where we are staying without an adult leader. 7. Participants who are unable to follow the group rules and expectations will be sent home at the parents expense. Please do not make us use this option!

2 (2) Dress Code 1. The following are not allowed at any time, except bedtime: Tank tops, spaghetti strap tops, low neck tops (no cleavage showing), halter tops, half or crop tops. Bare midriffs are not acceptable. This includes tying up t-shirts. (belly buttons should not be seen). Once in the sleeping and dressed for bed, youth will NOT be allowed outside the assigned girl or boy area. 2. T-shirts must not be offensive or display any slogan or artwork which includes alcohol, tobacco, or obscenities. 3. NO SHORT SHORTS (fingertip rule) Shorts or jeans must not sag either. We should not see your under garments (Please!). NOTES:

3 THINGS TO BRING ON SHIPROCK MISSION TRIP Sleeping Bag or Sheets/Blanket Pillow Towel Washcloth Bag for dirty clothes Sunscreen Hat Sunglasses Water Bottle Bandana/sweatband Mosquito Repellant Work Clothes Sturdy Work Pants Work T-shirts (clothes you can paint in & get really dirty!) Closed-toed Shoes (sneakers are fine) Toothbrush/paste Soap Shampoo Deodorant (Yes, Please!!!) Minimal Toiletries/Make Up Hair dryer Make Plans to Share! ****Medications Please check them in with Jesslyn Play/Travel Clothes Shorts T-shirts (no spaghetti straps or tank tops; no inappropriate words or pictures) Jacket Sandals Swim suit (2 piece must worn with t-shirt) Underwear Socks Sleep Clothes (appropriate for dorm living) Bible Notebook Camera Games for travel & free time Snacks to Share Cell Phone Policy: Cell phones will be allowed during travel times only. When we arrive, we ll collect phones and place them in a secure area (our dorm may not be entirely secure, so please do not leave them in your luggage). Cell phones may be used to call/text home during the week, but not to call/text/ friends or play games, etc. We ll make our own entertainment.it s a great group bonding experience!

4 (4) CUMC YOUTH MISSION TRIP TO SHIPROCK COVENANT As a participant with this mission trip, I agree that I will: 1. Conduct myself in a way which brings credit to my God, my church, my youth group, my family, and to me. 2. Sacrifice, at times, my own needs for the greater needs of the community of which I am a member. 3. Fully participate in all activities. 4. Adhere to all rules and expectations of CUMC Youth Missions presented in this packet and by adult leaders for entire trip including travel times, dress codes, safety measure and prohibited items. I understand that willful failure to follow these policies could result in my early return home. My parents will be notified and will be required to pay for the cost for transporting me home unaccompanied. Parents will also have the option of driving to New Mexico to pick you up and that would be a really long ride home! Youth Signature

5 (5) PARENTAL AGREEMENT FORM I agree to indemnify and hold harmless CUMC, its officers, agents, employees and volunteers from any and all claims, damages, expenses, or injuries arising out of or incident to my child s participation in this Mission Trip, unless such loss or injury results directly from neglect or willful act of an officer, agent, employee or volunteer of CUMC acting within the scope of his/her participation in this trip. Additionally, I understand that willful failure of my son/daughter to follow the policies written in this packet could result in his/her early return home with the costs being my responsibility. If my youth is asked to leave this trip early, I will be notified and asked to pre-pay the costs for my son/daughter s trip home. I understand and agree to a NO-TOLERANCE POLICY for youth using Tobacco, Alcohol, Firearms, Illegal Drugs, or Pyrotechnics. Youth Name You have my permission to use photographs, slides or videos in which my child, appears for Youth Mission Trip publicity purposes. Youth s name Parent/Guardian s Signature

6 2013 Shiprock Mission Trip/Medical History & Release Form Name of Birth Home Phone Cell Phone Home Address Address Health Insurance Co Policy# Family Physician Phone# Does your insurance company pay for (reimburse you) for emergency procedures out of state? (yes/no) Do they require a 2 nd opinion before emergency procedures are undertaken? (yes/no) Please check your individual policy to see. In case of emergency, please list names, phone #, and of people we should contact: Name Relationship Phone Name Relationship Phone The following information is required to ensure that your individual needs are met while on this mission trip. This information is confidential. of last tetanus shot Please list any physical or behavioral conditions we should be aware of: (sleepwalking, epilepsy, diabetes, fainting, depression, eating disorders, asthma, etc.) Please be specific so that we can provide you the best care in case of emergency: Are you allergic to any food, medication, or insect bites? (yes/no) If yes, please list the particular allergy and probable reaction: Are you currently taking any medications? YES/NO If yes, please list all medications you will be bringing with you including complete instructions for administering (in case of emergency) Unless absolutely necessary, do not change your prescription before your mission trip. We will be less likely than you to detect negative reactions to medications. If you are incapacitated, may we administer the following to you: aspirin (yes/no), aspirin substitutes (yes/no), eye ointments (yes/no), antihistamine or decongestant (yes/no), motion sickness medication (yes/no), laxative or anti-diarrhea medication (yes/no), antibacterial or antibiotic ointment (yes/no), insect bite or other ointment (yes/no) Note: If you require special care or diet, please contact us as soon as possible prior to arrival so that necessary arrangements can be made.

7 MEDICAL RELEASE AND LIABILITY RELEASE will be attending the Christ UMC Youth Mission Trip (name of participant) during the time period between July 6 July 13, I understand the program involves community service projects (working in fields & warehouses) and some recreational activities and I acknowledge reasonable measures will be taken to safeguard the health and safety of all participants. In case of a medical emergency I hereby authorize calling a physician to provide whatever medical or surgical treatment is necessary. I understand emergency contacts will be notified as soon as possible in case of any emergency. Your signature here confirms that the information on these 2 pages is complete and correct as far as you know and you are giving others permission as noted. Youth Signature We will need a copy (front/back) of your insurance card.