I have included this

Name:

Application with all questions fully answered/ signed

Mission Trip Agreement

Completed Parent Reference Form

Completed Personal Reference Form (This can be turned in separately, but must be in by January 4, 2015)

Completed 2015 Medical Authorization form (new forms required every January.)

Copy of Insurance Card

Copy of Photo ID

Deposit Check #

Over-the-Counter Medication Authorization (Optional)

T-Shirt size

Complete application at: benttree.org/families/student-missions

I confirm that I have included all of the items above.

Signature

Office Use Only

Incomplete applications will not be accepted. Late applications will be put on a waiting list.

I confirm that all of the items above have been received.

Signature

Office Use Only

2015 Student Missions Application

Trip List

Please be aware only a small percentage of students will beable to receive their top choice.

Costa Rica 2 10th-12th June 21-July 4

Student Application

For Students: Please complete the following questions: Your answers play a crucial role in team selection, please be as thorough as possible. SPIRITUAL WALK

1. Explain how you know that you are a Christian and tell the story of how you came to faith in God.

2. When given the opportunity, how would you encourage others to know Him?

3. What is something that God has taught you recently?

PERSONAL GROWTH ..........................................................................................................................................................................................................

..........................................................................................................................................................................................................

1. What do you think are your strengths and weaknesses and/or spiritual gifts (if known)?

2. How do you hope to be changed as a result of going on a trip?

3. How would you like to be challenged to grow?

Student Application

4. How do you respond to adversity/conflict?

5. If you have been on a mission trip before, what were your positive and negative experiences? What did you learn about yourself? What could you do better?

SERVICE ............................................................................................................................. ........................................................ 1. In what areas have you served at Bent Tree, in the community, or at your school over the last six months?

2. What other mission trips have you been on? What are your expectations for this summer?

MISCELLANEOUS ............................................................................................ ......................................................................................... 1. Who did you give your personal reference to?

Reference Reference Phone Number Email Address

2. Can you commit to attend the scheduled training meetings for the trips you are applying for? (Please see the Important Dates Sheet.) If you are unable to attend all meetings, this may effect participation.

Yes Not all of them Explain:

Mission Trip Agreement Student Parent Expectations for Participation (Please initial each expectation): Attend all training sessions with the team prior to the trip. Attend team building times and team retreat, if applicable. Discuss in advance with the team leader if a scheduling conflict arises. Approval must be obtained to miss a meeting. Maintain Christ-like character and behavior. Handle any and all medical needs/immunizations prior to the trip. Raise prayer and/or financial support. Pay acceptance fee as noted in trip booklet at first team/parent meeting February 15. Commit to: Praying before, during, and after the trip, submitting to the authority of the leaders, valuing unity of the team, and having a

flexible, servant attitude.

Payment Schedule If I am able to participate in the Mission Journey I commit to raise support and submit:

Percentage or Amount Deadline

See trip book for acceptance fee amount With approved application and/or by first team meeting

50% Within 2 months of departure

75% Within 1 month of departure

85% Within 2 weeks of departure

Balance Remaining Prior to departure

**Failure to adhere to these deadlines may result in removal from trip.

Student Parent Cancellation Procedure: Applicant must submit a letter in writing to the Student Missions Coordinator stating the reason they no longer wish to participate in the trip. Applicant must send a letter to supporters informing them of his/her decision to not go on the trip and advising them that support will go

towards others on the trip. For trips in June, cancellation must occur before March 1 for no additional costs to be incurred. If airline ticket has been purchased, student

will be responsible for that amount. For trips in July, cancellation must occur before April 1 for no additional costs to be incurred. If cancellation occurs after these dates, the applicant must pay the difference between the cost of the trip and amount of support raised. Plane tickets will be retained by Bent Tree for future use. If at least 50% of the fund raising is not in by the time to buy plane tickets, payment for that will be requested.

Student Parent Trip Guidelines: For medical expenses incurred during a trip, receipts will be obtained and given to the parent(s) upon return. Reimbursement to Bent

Tree needs to take place as quickly as possible. Filing claims with your insurance company is at your discretion and will not be done by Bent Tree and/or its staff.

If a student becomes ill and needs to return home, the expense will be the responsibility. If medically necessary, an adult will accompany the student. If not, the student will fly home unaccompanied.

If a behavior is deemed unacceptable by Bent Tree staff or its trip leaders, the student will be removed from the team or sent home at the s expense.

I agree to have my name posted on the Bent Tree Bible Fellowship website from January 23-25 for team placement decisions. If you do not give permission to have their name posted, sign here.

By signing this agreement, I am indicating that I would like to participate in a Bent Tree Bible Fellowship student mission trip, and I agree to all items contained in this agreement.

Name Signature Date

By signing, I/we understand and agree to the items contained in this agreement and agree to support our student fully in the mission trip process. Note: BOTH parents with legal guardianship rights must sign.

Parent or Guardian Signature Date

Parent or Guardian Signature Date

Mission Trip Agreement-Parent Copy

Student Parent Expectations for Participation (Please initial each expectation): Attend all training sessions with the team prior to the trip. Attend team building times and team retreat, if applicable. Discuss in advance with the team leader if a scheduling conflict arises. Approval must be obtained to miss a meeting. Maintain Christ-like character and behavior. Handle any and all medical needs/immunizations prior to the trip. Raise prayer and/or financial support. Pay acceptance fee as noted in trip booklet at first team/parent meeting February 15.

Commit to: Praying before, during, and after the trip, submitting to the authority of the leaders, valuing unity of the team, and having a

Payment Schedule If I am able to participate in the Mission Journey I commit to raise support and submit:

Percentage or Amount Deadline

See trip book for acceptance fee amount With approved application and/or by first team meeting

50% Within 2 months of departure

75% Within 1 month of departure

85% Within 2 weeks of departure

Balance Remaining Prior to departure

Student Parent

**Failure to adhere to these deadlines may result in removal from trip.

Cancellation Procedure: Applicant must submit a letter in writing to the Student Missions Coordinator stating the reason they no longer wish to participate in the trip. Applicant must send a letter to supporters informing them of his/her decision to not go on the trip and advising them that support will go

towards others on the trip. For trips in June, cancellation must occur before March 1 for no additional costs to be incurred. If airline ticket has been purchased, student

will be responsible for that amount. For trips in July, cancellation must occur before April 1 for no additional costs to be incurred. If cancellation occurs after these dates, the applicant must pay the differencen between the cost of the trip and amount of support raised. Plane tickets will be retained by Bent Tree for future use. If at least 50% of the fundraising is not in by the time to buy plane tickets, payment for that will be requested.

Student Parent Trip Guidelines: For medical expenses incurred during a trip, receipts will be obtained and given to the parent(s) upon return. Reimbursement to Bent

Tree needs to take place as quickly as possible. Filing claims with your insurance company is at your discretion and will not be done by Bent Tree and/or its staff.

If a student becomes ill and needs to return home, the expense will be the paren responsibility. If medically necessary, an adult will accompany the student. If not, the student will fly home unaccompanied.

If a behavior is deemed unacceptable by Bent Tree staff or its trip leaders, the student will be removed from the team or sent home at the expense.

I agree to have my name posted on the Bent Tree Bible Fellowship website from January 23-25 for team placement decisions. If you do not give permission to have their name posted, sign here.

By signing this agreement, I am indicating that I would like to participate in a Bent Tree Bible Fellowship student mission trip, and I agree to all items contained in this agreement.

Name Signature Date

By signing, I/we understand and agree to the items contained in this agreement and agree to support our student fully in the mission trip process. Note: BOTH parents with legal guardianship rights must sign.

Parent or Guardian Signature Date

Parent or Guardian Signature Date

Parent Reference/Recommendation Form Student Name:

Your student is currently being evaluated for participation on a short-term mission trip. We would appreciate your candid response to the following questions to assist us in the evaluation process.

Parent(s) Name:

1. Do you fully support your desire to go on a mission trip? Y N

2. What do you feel are your greatest strengths?

3. In your opinion, in what areas does your student need to grow?

4. Do you see your student as a positive influence within their friend groups? Explain.

5. When in conflict, what is the best way to approach your student? How do they respond?

6. What are you hoping to see happen in your life?

Authorization to Permit Use of Over-the-Counter Medications

Name: Date of Birth:

Current Age: Current Weight:

I permit my student to take/use the following over-the-counter medications (or their generic equal) according to manufacturer"s directions, should my

student report a minor complaint to one of the trip leaders. (i.e., headache, muscle pain, stomach ache, small cuts, blisters, sunburn, etc.) All medications are to be dispensed by an adult trip leader.

Tylenol Advil Aspirin

Head/Cold Congestion relief

Anti-Diarrheal Benadryl/Antihistamine

Dramamine Aloe Vera Sunscreen

Pepcid/Tums Cough Drops

Parent Signature

Date Signed

THIS AUTHORIZATION EXPIRES DECEMBER 31, 2015

Personal Reference/Recommendation Form

Applicant Name: Grade:

The above named applicant is currently being evaluated for participation on short term mission trip. We would appreciate your candid response to the following questions to assist us in the evaluation process. Your responses will be kept confidential.

Evaluator Name:

Phone: Email:

1. How long have you known the applicant? What is your relationship to him/her?

2. In what ways do you feel the applicant is an influence on others?

3. What are the first words that come to your mind to describe this student?

4. In your opinion, in what areas does the applicant need to grow?

Please indicate your knowledge of the

abilities as compared with those

his/her age.

*Please return to Lauren Fuston, Bent Tree, 4141 International Pkwy, Carrollton, TX 75007 by 1/4/2015. To be completed by a Bent Tree Student Ministries leader or other Bent Tree attender.

Please indicate yourknowledge of the

abilities ascompared with those

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Motivation Initiative Capacity for growth Concern for others Self-confidence Integrity Spiritual maturity Respected by peers Responsibility Ability to Communicate

Student Missions Important Dates 1/23/15 Teams Announced on Bent Tree Website 5:00pm 1/24/15 Team Introduction Meeting 2:00 pm - 3:00 pm

1/24 /15 Jeff Allen Comedy Night 3:00 pm - 9:00 pm

2/15/15 Parent Meeting/Meeting #1 1:00 pm - 3:00 pm(MS)

3:00 pm - 5:00 pm(HS)

3/1/15 Meeting #2 1:00 pm - 3:00 pm(MS)

3:00 pm - 5:00 pm(HS)

3/29/15 Meeting #3 1:00 pm - 3:00 pm(MS)

3:00 pm - 5:00 pm(HS)

5/3/15 Meeting #4 1:00 pm - 3:00 pm(MS)

3:00 pm - 5:00 pm(HS)

5/31/15 Parent Meeting/ Meeting #5 1:00 pm - 3:00 pm(MS)

3:00 pm - 5:00 pm(HS)

3:00 pm - 5:00 pm

6/3/1 5 Missions Festivus 7:00 pm - 8:30 pm

The following teams will have service weekends:

4/10 - 4/12 Los Angeles 2, Honduras, Costa Rica 14/17 - 4/19 Los Angeles 1 (at Father/Teen Retreat)4/24 - 4/26 Costa Rica 2, Navajo, Joni & Friends