Mission Tucson June 12th -21st, 2015 Approximate cost: $700

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1 2015 Mission Trips We are so excited that you are interested in applying for a 2015 Mission Trip! We want to help you understand our heart for why we do mission trips. We truly believe that it is not about us having a great experience, though many do, but rather about reaching the lost and serving God s family. We intentionally forget about our needs and ourselves, and focus on serving others in love. We are called to follow the spiritual mandates of Matthew 28:19 Therefore, go and make disciples of all the nations, baptizing them in the name of the Father and the Son and the Holy Spirit. and Acts 1:8 But you will receive power when the Holy Spirit comes on you; and you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth. We are excited to offer up the following mission opportunities for Mission Tucson June 12th -21st, 2015 Approximate cost: $700 Who can apply? High School Students Experience Southwestern U.S. culture, climate and diversity during your Tucson mission trip. Tucson mission opportunity gives you and your team a chance to share Christ's love, mature your faith and meet the practical, physical and spiritual needs of people who live in Arizona's second-largest city. You may find yourself serving in the inner city, a Native American village or, a mining town as your team members exercise their gifts, abilities and interests and play sports, teach children, or complete other projects with your partner church. Join us for this great opportunity to partner with local churches whose style and flavor are different from our own. We know that this week of serving will stretch your faith and establish ongoing relationships as we return in future years. Trinidad July 2nd July 13th, 2015 Approximate cost: $1500 Who can apply? High School Students with mission trip experience The Trinidad mission trip offers us an opportunity to continue to develop our long-standing relationships with the local church and people of this amazing Caribbean Island. We will be spending approximately days serving alongside our local partners as we minister to the impoverished, sick, orphans, and the unloved. This intense self-sacrificial trip will push boundaries and be an amazingly blessing for you and the people of Trinidad. This trip focuses on building relationships, sharing Christ love, and serving both the spiritual and physical needs of the people we encounter. God has used this trip to change its participants and our brothers and sisters in Trinidad in miraculous ways. Trinidad note - Due to the airfare for this trip there can be some details that are not fully determined until after the application process. The cost of this trip will be based on the price of airfare. Until the reservations have been made, the flight times and layovers may impact the exact start and end dates of the trip. These trips are about coming together to serve, learn, worship, pray, and love each other. The goal is to make Jesus famous around the world and to live the transformed life found in God's Word. We pray that these missions will not just end when we come home, but will become a lifestyle that we embrace. Our hope is that each student is changed through the relationships we build and the missions that we have started. Acts 20:24 I consider my life worth nothing to me; my only aim is to finish the race and complete the task the Lord Jesus has given me the task of testifying to the good news of God s grace. Join us.

2 Next Steps If you are interested in participating in one of these mission trips, here are the steps that you need to take: First step:! Please take home the application form provided to you by your campus youth pastor and talk to your parents about the mission trips.! Pray! Ask God to guide your heart. Choose a mission trip to apply for. Second step fill out the application:! Fill out the application neatly and completely. Please keep in mind this is an application, completion of it does not guarantee acceptance.! Your parents will need to fill out the Parent Section before you turn in your application Third step Notarize!! The Liability & Medical Release form must be notarized for ALL mission trips before you turn in your application.! For Trinidad, you will also need to have the Permission to Travel page notarized. This must be done before you turn in your application. Last step before turning in your application:! Attach a check made out to The Chapel for $75 for the application fee. If your application is not accepted, the check will be returned. If your application is accepted, the deposit will go towards your trip as a donation. Important Notes and Parent Information:! All of the above steps need to be complete prior to turning in your application. It will not be accepted if you are missing notarization and the parent letter.! For Trinidad: proof of passport or a passport application must be turned in by March 31, 2015.! Pending travel expenses, final costs of the mission trips have not yet been determined. Payment! All mission trips must be paid in full by June 1st an approved payment plan has been arranged ahead of time.! Important Dates All completed applications are due by Wednesday, January 15 th, Students will be notified if they have been selected by Sunday January 18 th, 2015 Mandatory Missions Meetings There will be mandatory meetings for Tucson & Trinidad on Feb 7 th and then once a month each month until June, these will be set and communicated by the mission trip leaders. Questions??? Talk to your campus youth pastor or contact the Student Ministries Administrator Bre Kingsley at bkingsley@chapel.org or by calling (847)

3 2015 Mission Trip Application Must be turned in by Wednesday, January 15 th, 2015 Applicant Information Preferred name First name Last name Birth date (mm-dd-yyyy) Age Female " Male " Home address City, State, Zip Code Home phone Cell Phone address T-shirt size: " Adult Small " Adult Medium " Adult Large " Adult X-Large " Adult 2XLarge I regularly attend the campus at: "Barrington "Grayslake "Libertyville "Mundelein "McHenry "Lake Zurich " Palatine "Hinsdale Mission Trip Selection I am applying for: " Tucson June 13 th 22 nd, 2015 " Trinidad July 2 nd July 13 th, 2015 Parent/Guardian Contact Information First name Last name Home address City, State, Zip Code Work phone Home phone Cell Phone address Relationship to applicant

4 Emergency Contact Information In the case we are unable to reach a parent/guardian, please provide us with an emergency contact. First name Last name Home address City, State, Zip Code Work phone Home phone Cell Phone address Relationship to applicant Confidential Health History Form (Please Print) INSTRUCTIONS: Please answer all questions by marking X in the YES or NO boxes. Explain any Yes answers in the space below. Have you ever had, or do you have any of the following: Yes No Allergies " " Asthma " " Epilepsy/Seizures " " Hypoglycemia/Diabetes " " Are you now under a doctor s care for any condition? If yes, please explain below. Are you taking any medication at this time? If so, what are you taking and why? Any physical handicaps or health conditions which require special attention? Date of last tetanus shot: Please use the section below to clarify any yes answers from above. If taking prescription medication, please be specific and include type and dosage.

5 Supplemental Questions Please answer all the questions below. Use separate sheet of paper if additional space is needed. Please include the line #. 1. When did you make the decision to trust and follow Jesus as your personal Lord and Savior? 2. Describe your walk with Christ since you made that decision. (Please use an additional sheet of paper if necessary.) 3. Have you been on a mission trip before? If so, where? 4. Why do you want to go on this mission trip? 5. What expectations do you have for this mission trip?

6 Parent Section: Your participation and support is appreciated by all of us in Student Ministries, thank you for your support! You play a vital role in the mission trip process in which you student is embarking. In helping set up the students for success we are asking for parents to take the roles of campus representatives. Parents from respective campuses will work closely with the campus youth pastor. Parents will help with tasks such as administrative, organizing lobby fundraising as well as large fundraising planning and execution. By signing this application I (the parent) understand that my family is responsible in supporting my child monetarily, physically, spiritually and mentally. I promise to help the participant in raising the funds and participating in the mission trip meetings to the best of my ability. I promise to attend/chaperone 2 fundraisers. I understand that we are responsible to cover the cost of the trip if the funds are not fully raised by fundraisers. I promise to help keep track of times and dates to insure that my child is on time to meetings and events. I will do everything in my power to keep the leadership of the trip appraised of any conflicts or issues. I understand that my child maybe asked to give up their spot on the trip if we fail to meet the minimum requirements. Finally, I understand that my participation and encouragement is vital to the overall group mentality. I agree to support my child and the mission group in this mission trip in every way that I can. Parent Signature(s): Phone Number (s): Address (s): Best Time To Reach You: Best Method To Reach You: Campus You Attend:

7 Parent Section Please take the space below to explain why you believe your child is ready to go on this mission trip.

8 Liability & Medical Release (Please read carefully, sign your name in the presence of a notary.) I hereby release, acquit, and discharge The Chapel and its employees, agents, and authorized representatives from all damages, injuries, claims, demands, or causes of action that I, or any family member, my heirs, executors, administrators, or assigns may have arising out of this short-term outreach. Additionally, I authorize The Chapel and its employees, agents, and authorized representatives to consent to any emergency medical treatment that be deemed necessary to the person(s) named below. I assume responsibility for any and all costs for such emergency medical treatment. Please print: Applicant s first name Last name Applicant s signature (signifies agreement) Date IMPORTANT: Law requires signatures from both parents or legal guardians who have legal custody of a minor under the age of 18. If only one parent or guardian has custody, then only one signature is required. NOTICE: If a parent or legal guardian s last name is different from the minor s last name it is STRONGLY recommended that the minor travel with original (or certified true copies) of marriage certificates, adoption documents, certificates of name change or any other document proving the parent/guardian and child relationship. This is even recommended if the child will be carrying a passport identifying the parent/guardian. Please print: First name of 1st parent/guardian Last name Signature of 1st parent/guardian (signifies agreement) Date First name of 2nd parent/guardian Last name Signature of 2nd parent/guardian Date Important: " Please check this box if there is only one legal guardian and provide the appropriate documentation. Notarization County, State/Province Sworn to and subscribed before me on this date: First name of Notary M.I. Last name of notary (Please print) Notary seal/stamp here Signature of notary

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10 For The Trinidad Mission trip Only Permission To Travel (for participants under the age of 18 ONLY) Participant s full last name, middle initial, first name (please print clearly): This form certifies that: (Please print full name of applicant) has the permission of I/we, the undersigned parent(s)/guardian(s) to enter Trinidad/Tobago in company with The Chapel, its employees, agents, and authorized representatives. Thank you for permitting entrance to your country. IMPORTANT: Law requires signatures of both parents, or legal guardians who have legal custody of a minor under the age of 18. If only one parent or guardian has custody, then only one signature is required. NOTICE: If a parent or legal guardian s last name is different from the minor s last name it is STRONGLY recommended that the minor travel with original (or certified true copies) of marriage certificates, adoption documents, certificates of name change or any other document proving the parent/guardian and child relationship. This is even recommended if the child will be carrying a passport identifying the parent/guardian. Please print: First name of 1st parent/guardian Last name Signature of 1st parent/guardian (signifies agreement) Date First name of 2nd parent/guardian Last name Signature of 2nd parent/guardian Date Important: Check this box if there is only one legal guardian. " to show there is one legal guardian. Please provide appropriate documentation Notarization County, State/Province Sworn to and subscribed before me on this date: First name of Notary M.I. Last name of notary (Please print) Notary seal/stamp here Signature of notary