Mission To Madison - Leader Registration

Mission to Madison is a mission trip for middle school students. The trip will include daily various service projects around Madison, evening devotions, and fun nightly activities. Students and leaders will stay overnight at HPC.

Week 1: 6/9/24 - 6/14/24

Week 2: 6/23/24 - 6/28/24

***Save the date: June 2, 2024 Leader Training Meeting (w/lunch, after church at 12pm)***

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Select Leader Commitment: *
Which Mission to Madison week would you prefer?
You are most likely to get the week you prefer, unless we specifically ask you otherwise. If you CANNOT attend 1 of the weeks, please also select "Other" and explain below so we know to not place you on that week *
Required
Can you attend the leader training meeting on Sunday, June 2, 2024 from 12-1pm
Evening fun leaders are not required to attend the leader training, you are invited to join but it's more of a training for the main leaders going on the full week *
First Name *
Last Name *
Your Email: *
Phone Number: *
Address: *
Include mailing address, city, state, zip code
Medical or Behavorial issues
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Any medical or behavioral issues that you have that would be helpful for us to know about? If yes, please explain and include what accommodations may be needed.
Emergency Contact Full Name:
 *
Emergency Contact Phone Number:
 *
Emergency Contact Relationship to You:
 *
Allergies
 *
Do you have any food allergies? If yes, please explain and include treatment.
Your tshirt size: 
All sizes are gender neutral, adult sizes *
Participant Agreement Acceptance
PLEASE READ THE PARTICIPANT AGREEMENT CAREFULLY and sign below to indicate your agreement with all statements made in this section.
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I acknowledge that participation in this Student Ministry activity involves risk to the Participant (and to Participant’s parents or guardians, if Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage and financial damage. In consideration for the opportunity to participate in the activity described above (the “Activity”), the Participant (or parent/guardian if Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Activity or during transportation to and from the activity, as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Activity Sponsor”). Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the Activity Sponsor for any injury arising directly or indirectly out of the described Activity or transportation to and from the Activity, whether such injury arises out of the negligence of the Activity Sponsor, the Participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and the Activity Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution pursuant to the rules of the American Arbitration Association.
Required
Model Release Acceptance Required

PLEASE READ THE MODEL RELEASE CAREFULLY and indicate your agreement with all statement made.  IF YOU HAVE BEEN A VICTIM of a sensitive or violent crime, or any other situation that puts your safety at risk because your likeness is used publicly, please provide written documentation to Paxton Bauer.

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I hereby grant to High Point Church, Inc., voluntarily and with full understanding, the following: Use and storage of my name and image, by means of digital or film photography, video photography, audio recording, or other documentation. This is with respect to any Student Ministry activity, of High Point Church. I further authorize High Point Church, Inc. to use these electronic images, photographs, and/or video recordings in any manner—whole or in part. This waiver includes the usage of this media in any way deemed appropriate, which may include electronic and photographic reproductions thereof for the production of educational, instructional, promotional, or informational materials which support the activities of High Point Church, Inc. All images, photography, and video shall become the complete property of High Point Church, Inc. I also hereby waive any right I may have to inspect or approve any use of this electronic image, photograph, and/or video. I release High Point Church from all liability which could result from its use. No payment has been promised, made, or is anticipated. I have read and fully understand the contents of the release. This release shall be binding upon me and my heirs, legal representatives, and assigns. If I am signing this agreement on behalf of a minor child, I hereby warrant that I am the legal parent or guardian of the child and that I have the legal authority to sign this agreement on behalf of the child.
Required
Sign Full Name here in agreement with the waivers above: *
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