C:\Hard Drive From Pen Drive 9 - Missionaries for America Program

Application
Please mark the event(s) for which you
are making application:
I.B.U. (Intense Biblical Upload for adults),
Paragould, AR, September 24-26
Mini-MAP, DeRidder, LA, February 12-16
MAPster, Paragould, AR, October 15-17
Ladies Retreat, Paragould, AR, March 19-21
MAP Winter Retreat, Paragould, AR, December
28 - January 1
Missionaries
for America
Program
Unplugged, Paragould, AR, April 16-18
June “Month of MAP”, May 30 - June 26
(Includes Homemade Roles, Woodland Bible
Camp and Mission One shown below)
Homemade Roles, Paragould, AR,
May 30 - June 4
Woodland Bible Camp,
Dugger, IN, June 6-12
Mission One: "Boot Camp" (Intense
mission training week), Paragould, AR
and "Boots on the Ground" (Service
point), Kentucky Christian Camp, Crab
Orchard, KY, June 12-26
July “Month of MAP”, July 4-30
(Includes Mini-MAP, Mission Two and Christian Youth Encampment shown below)
IMPORTANT: Please send the application, parental consent form and all other
necessary items at least 20 days before
the event. Please use one form per
participant per event.
missionariesforamerica.com
Your Name:
Parent or guardian's name(s):
Address:
City:
State:
Zip:
Phone:
E-mail:
Mini-MAP, Little Rock, AR, July 4-8
2010
M.A.P.
Events
Your birth date:
Mission Two: "Boot Camp" (Intense
mission training week), New Albany, IN
and "Boots on the Ground" (Service
point), Denham Springs, LA, July 10-23
T-shirt size:
Your congregation:
Christian Youth Encampment, DeRidder,
LA, July 25-30
Make all checks out to M.A.P.
Send to: M.A.P. - P.O. Box 131 - Paragould, AR 72451
M.A.P. - P.O. Box 131 - Paragould, AR 72451
2010 M.A.P. Events
Mini-MAP, DeRidder, LA
February 12-16
Cost: $40
A four-day miniature version of the summer
MAP experience.
Ladies Retreat, Paragould, AR
March 19-21
Cost: $35
Ladies 18 and over will enjoy a weekend focusing on their needs as Christian women.
Unplugged, Paragould, AR
April 16-18
Cost: $35
A weekend dedicated to the celebration of vocal
worship.
June MAP
Events below can be attended separately or
packaged together as one long "month of MAP".
When packaged together, the cost is $600. This
amount covers all expenses for the month as
well as extra food, activities and transportation
between events.
Homemade Roles, Paragould, AR
May 30 - June 4
Cost for this event only: $95
Woodland Bible Camp, Dugger, IN
June 6-12
Cost for this event only: $100
Mission One: "Boot Camp" (Intense mission
training week), Paragould, AR and "Boots on
the Ground" (Service point), Kentucky
Christian Camp, Crab Orchard, KY
June 12-26
Cost for this event only: $350
July MAP
Events below can be attended separately or
packaged together as one long "month of MAP".
When packaged together, the cost is $600. This
amount covers all expenses for the month as
well as extra food, activities and transportation
between events.
Mini-MAP, Little Rock, AR
July 4-8
Cost for this event only: $40
Mission Two: "Boot Camp" (Intense mission
training week), New Albany, IN and "Boots
on the Ground" (Service point), Denham
Springs, LA
July 10-23
Cost for this event only: $350
Christian Youth Encampment, DeRidder, LA
July 25-30
Cost for this event only: $100
I.B.U. (Intense Biblical Upload for adults),
Paragould, AR
September 24-26
Cost: $35 ($50 per couple)
MAPster, Paragould, AR
October 15-17
Cost: $35
A campout designed to provide survival training,
experience and readiness.
MAP Winter Retreat, Paragould, AR
December 28 - January 1
Cost: $75
A four-day miniature version of the summer
MAP experience.
Parental Consent Form
To whom it may concern: The undersigned does hereby
give permission for the child named on the back of this
paper, to attend and participate in activities sponsored
by The Missionaries for America Program on the
following dates:
Signature(s) of legal guardian(s):
We (I) authorize an adult, in whose care the minor has
been entrusted, to consent to any X-ray examination,
anesthetic, medical, surgical or dental diagnosis or
treatment, and hospital care, to be rendered to the
minor under the general or special supervision and on
the advice of any physician or dentist licensed under
the provisions of the Medical Practice Act on the
medical staff of a licensed hospital, whether such
diagnosis or treatment is rendered at the office of said
physician or at said hospital.
The undersigned shall be liable and agree(s) to pay all
costs and expenses incurred in connection with such
medical and dental services rendered to the aforementioned child pursuant to this authorization.
Should it be necessary for our (my) child to return home
due to medical reasons or otherwise, the undersigned
shall assume all transportation costs.
The undersigned does also hereby give permission for
our (my) child to ride in any vehicle designated by the
adult in whose care the minor has been entrusted while
attending and participating in activities sponsored by
the Missionaries for America Program and/or the
Homemade Roles Retreats.
Hospital insurance:
Yes
No
Insurance company:
Policy number:
Signature(s) of legal guardian(s):
Emergency numbers:
Send to: M.A.P. - P.O. Box 131 - Paragould, AR 72451