July 25 - 29 - Friendship Church

2016 student Information
STUDENT
MINISTRY
Josh Anderson
Prior Lake Zone Director
[email protected]
952-447-0540
Neil Johnson
Shakopee Zone Director
[email protected]
952-567-6482
For students going into
GRADES 5 - 6
Misti VanDommelen
(registration questions)
[email protected]
952-567-6462
July 25 - 29
Monday thru Wednesday: 3:00 - 9:00pm
Thursday: 3:00 - Overnight
Friday: All day at Water Park of America
17741 Fairlawn Avenue, Prior Lake, MN 55372
12800 Marystown Road, Shakopee, MN 55379
952-447-8282 | www.friendshipmn.org |
friendshipmn
@friendshipmn
*Dinner is included in the price. Your
student can bring a sack dinner if a meal
does not appeal to them, but the cost of
camp will stay the same.
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Paren
FROG Camp is a five
day event. Students
are expected at every
session. Please plan
accordingly.
On Friday we will be
going to Water Park
of America . This is
part of FROG Camp.
Students who have
not attended camp
will not be able to
come. Students who
go to camp but do
not go to Water Park
of America will not be
given discounts. If you
have questions about
this policy please
contact Mike Golay,
Pastor of Student
Ministry (interim).
WHEN? WHERE?
July 25 –29
Monday – Wednesday:
3:00 – 9:00pm, Shakopee Campus
Thursday:
3:00 – Overnight, Shakopee Campus
Friday:
All day at Water Park of America
Return to the Shakopee Campus
at 5:30pm
Cost?
$60 on or before June 19
$65 June 20 - July 3
(Financial Aid Application deadline July 3)
$75 July 4 - 17
No registrations after July 17
(Price includes dinner and a t-shirt)
What To Bring :
Bring Every Day!
Bring Thursday!
Bible
3-ring binder
2 pens/pencils
Clothes that can get dirty
Tennis shoes (no flip flops)
Bug repellant
Sunscreen
$$ for Canteen ($2 a day
maximum)
Swimsuits*
*Ladies: One piece bathing suit or
Sleeping bag/pillow
Pajamas
Toothbrush
Toothpaste
Deodorant
Flashlight
FROG Camp t-shirt
Superhero costume
(for Superhero Night!)
tankini that completely covers the
midriff is appropriate.
DO NOT BRING!
Bad attitudes, cell phones,
iPods (of any kind), other
electronic devices or
fireworks.
REGISTER !
Register online at www.friendshipmn.org/zone
or contact Misti VanDommelen at
[email protected] or 952-567-6462.
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RELEASE OF LIABILITY AND DISCIPLINARY POLICY
Please initial next to each statement:
_____ I understand I or my student will be held to the following code of conduct: Respect
property, one another, staff and adult leaders. NO fighting. NO alcohol, drugs or
tobacco. NO lighters. NO weapons, fireworks or explosives. NO students under age
19 are permitted to drive for events. NO boys in girls’ sleeping quarters and vice
versa. NO offensive or immodest clothing (girls bathing suits are to be one piece or
tankinis that completely cover the abdominal area). Participation with the group is
expected. Respect for and participation in scheduled events is expected.
_____ I/We authorize appropriate and lawful disciplinary action in the case of misconduct
by my student. I/We understand that misconduct may result in transportation home
from an activity at the parents’ expense. A student dismissed for a disciplinary reason
will not receive a refund of the activity fee.
_____ I/We consent to the following Discipline Procedure: 1. The student is warned privately
whenever possible and publicly if necessary. 2. The student is separated from the
group and given specific course for correction. 3. The student is removed to the
parent. Students will not be permitted to return to any program or event until a
meeting between the ministry director and the parent is scheduled.
_____ I/We grant permission for medical treatment. I/We grant permission to the
representative(s) of Friendship Church to provide the necessary acute treatment to
me/our student prior to my/their need for admission to a medical facility. I/We also
acknowledge that we will be ultimately responsible for the cost of any medical care
should the cost of that medical care not be reimbursed by the health insurance
provider. I/We affirm that the health insurance information provided is accurate at
this date and will, to the best of my/our knowledge, still be in force for the student
named above. I/We consent to any reasonable medical treatment as deemed
necessary by a licensed physician. I/We authorize any such medical provider to
perform all procedures deemed medically necessary in attempting to treat or relieve
any injuries or illnesses. I/We consent to the administration of anesthesia as deemed
advisable. I/We realize and appreciate that there is a possibility of complications
and unforeseen consequences in any medical treatment. I/We assume any such risk
for and on behalf of myself and/or said minor. I/We understand that attempts will be
made to contact a parent, guardian or alternate emergency contact in the most
expedient way possible.
_____ I/We agree to bring my/our child home at my/our own expense should they become
ill or if deemed necessary by the Student Ministry staff member.
_____ I/We authorize that my child’s name, image and/or likeness may be photographed
or filmed and used in videos, printed publications, websites, social networking
sites and presentations by the staff of Friendship Church. I/We also understand
that photographs posted by fellow students are not the responsibility of Friendship
Church.
_____ I/We the undersigned have legal custody of the minor student named, and give our
consent for him/her to attend this event being organized by Friendship Church.
_____ I/We understand that cell phone/electronics are not allowed at camp.
_____ I hereby assume the risks and responsibilities stated on this form on behalf of myself or
the afore named child. I/We understand that there are inherent risks involved in any
event, and I/We hereby release Friendship Church, its pastors, employees, agents
and volunteer workers from any and all liability for any injury, loss, or damage to
person or property that may occur during the course of my/our child’s involvement.
STUDENT MINISTRY
Financial Aid Request Form
FROG Camp - July 25 - 29, 2016
Financial Aid Requests are due Sunday, July 3
GRADES 5 - 6
OFFICE:
Date: ______
Time: ______
Dep $: _____
Initial: ______
Requests received after this date will not be considered.
Aid is available due to the generosity of Friendship Church attendees.
Offers are made on a case-by-case basis and based on the price of $65. All
offers are prayerfully considered. All requests are confidential.
Generally we are able to offer some help based on funds available and number
of requests received. After Monday, July 11, Pastor Mike will email Friendship’s
specific financial aid offer to you.
You must accept the offer by replying no later than Sunday, July 17. Failure to
reply may result in forfeiture of any offer made.
Please return the completed and signed request form to Misti VanDommelen.
FINANCIAL AID OPTIONS:
Before submitting a request, please prayerfully consider which option is best for
your circumstance:
Pay Now, Pay Later: make a payment now and complete the full early price
payment over time. Payment must be complete by no later than 12/31/16.
Half Scholarship: pay half right now and request the other half be completed by
Friendship Church.
Partial Scholarship: make a payment now and request the other portion be
completed by Friendship Church.
If you make an advance payment, but are unable to accept the financial aid
offer, you will be fully reimbursed within 14 days of your formal written refusal of
the financial aid.
CONTACTS:
Student Ministry Pastor (interim)
Mike Golay | [email protected] | 952-567-6464
Student Ministry Admin
Misti VanDommelen | [email protected] | 952-567-6462
A parent/guardian must sign if participant is under age 19.
Signature: _____________________________________________________________
Print Name: ______________________________________ Date: _______________
17741 Fairlawn Avenue, Prior Lake, MN 55372 | 12800 Marystown Road, Shakopee, MN 55379
952-447-8282 | www.friendshipmn.org | friendshipmn
@friendshipmn
Financial Aid Request Form
ALLERGIES/ASTHMA
FROG Camp - July 25 - 29, 2016
This participant carries an:
PARENT INFO - REQUIRED
Parent First and Last Name: _______________________________________________
REQUIRED Parent Email: _________________________________________________
Home Phone: _________________ Cell Phone: ___________________
Select the form of Financial Aid you are requesting:
_______ Pay Now, Pay Later - Amount I can pay now $________________ (attach)
Date Payment will be completed: ___ / ___ / 2016 (no later than 12/31/16)
_______ Half Scholarship — Please attach $32.50 NOW
_______ Partial Scholarship - I can pay this much $___________________ (attach)
Briefly explain your need for financial assistance: _______________________________
______________________________________________________________________________
______________________________________________________________________________
FORM OF ATTACHED PAYMENT
Youth Worker Account - Amount: $______________
S
M
L
XL
Prior Lake
I regularly attend:
Wednesday
Parent AND student under age 18 MUST check in ALL medications TOGETHER with
the camp nurse or other designated staff member.
If your student takes daily medications, we kindly request that you PLEASE SEND
THEM along in their ORIGINAL containers inside a Ziploc bag labeled with the
student’s full name and home phone number. Please do NOT send over-thecounter medication.
MEDICATIONS:
1) Med Name: _________________________________ Dose (mg, etc.): ____________
Treating: _____________________ Side Effects: _______________________________
2) Med Name: __________________________________ Dose (mg, etc.): ___________
Policy#: _____________________________________________ Group #: ________________
Gender:
Grade 5
Campus I attend:
MEDICATIONS – DO NOT PACK IN LUGGAGE/BACKPACKS
Medical Insurance Company: _________________________________________________
Last Name: ____________________________________ First Name: ___________________
Grade in the fall of 2016:
Allergy: ________________________________ Reaction: ___________________________
PARTICIPANT’S MEDICAL INSURANCE INFORMATION
XXL
PARTICIPANT INFO (Student)
Birth Date: __ __ / __ __ / __ __ __ __
Please explain any allergies:
If you need additional space, please attach a piece of paper.
Total Payment Enclosed: $_________________
14-16
Arrangements for students to carry inhalers/EpiPens will be made at check in with
the nurse or other designated staff member.
Treating: _____________________ Side Effects: _______________________________
Check:$_______________ Check #_____________
T-SHIRT SIZE:
Inhaler
Allergy: ________________________________ Reaction: ___________________________
FINANCIAL AID REQUEST - Based on event cost: $65
Cash: $_______________
EpiPen
M
F
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Grade 6
Shakopee
Sunday
Visitor
Both Wed. & Sun.
Other information we should be aware of:
Visiting
Discussion Group Leader(s): ___________________________________________________
I am visiting with: _____________________________________________________________
I would like information about the Student Ministry at Friendship.
I am a one time event visitor. Do not send me information.
Primary Home Address: _______________________________________________________
City: ____________________________________State: _____________ Zip: _____________
Student Phone: (H) ____________________________ (C) ___________________________
EMERGENCY CONTACT INFORMATION
Child lives with:
Both Parents
Contact Data: Parent/Guardian Father
Mother
Other: _______
Secondary Contact
Full Name
_______________________________ _______________________________
Home Phone
_______________________________ _______________________________
Cell Phone
_______________________________ _______________________________
Email
______________________________________________________________
Relationship
______________________________________________________________
*Dinner and a tshirt are included. You
can bring a sack dinner if a meal
does not appeal to you.
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No rs WHEN? WHERE?
Sunday, July 24
Leade
FROG Camp is a five
day event. Leaders
are necessary at
every session for the
entire time.
There is a
MANDATORY leader’s
meeting on Sunday,
July 24. You will learn
what leaders and
students are on your
team, go through
the entire week
long schedule and
answer questions.
We will also spend
some time in prayer
for students and
decorate the church.
This is a CRITICAL
meeting! Please plan
accordingly.
Mandatory Leader Meeting
12:15 – 3:00pm, Shakopee Campus
July 25 –29 - FROG Camp!!
Monday – Wednesday:
3:00 – 9:00pm, Shakopee Campus
Thursday:
3:00 – Overnight, Shakopee Campus
Friday:
All day at Water Park of America
Return to the Shakopee Campus at 5:30pm
Leader Cost? FREE!
REGISTER!
Leaders, please register online at
www.friendshipmn.org/zone or with
Misti VanDommelen by July 17.
WHo?
We need adults and high school students who LOVE
JESUS to play games, lead small groups, help 5th and
6th graders learn to Fully Rely On God, pray with them
and listen to them! But, mostly have FUN with them!!!
Basic daily schedule:
Our students NEED you as the leader to have fun and
help assure they are on time and PREPARED!! You will
have a TON of fun in the process! But, we need leaders
for the WHOLE time!
3:00 3:00-3:30 3:30 4:00 4:30 6:00 6:30 7:00 7:45 8:50 9:00 Arrival, Check In
Gym Games
Intro (Gym)
Dinner (Commons)
Worship/Chapel
Small Groups
(Leader’s Choice)
Memory Verses
Skills/Canteen
(as TEAMS)
Team Games (Chapel)
Snack Time (Commons)
Parent Pick Up
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