HYG Registration 2014-15

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This form requests contact and medical information throughout the year for all youth participating in the Hancock Youth Group. Information provided in this document will be kept on file at Hancock Church and transported with youth leaders and chaperons to all off-site trips in compliance with the Hancock Safe Church policy. Should any of your youth's information change over the course of the year, please contact the church office (office@hancockchurch.org) to update the files. Information included on this form may be requested again for overnight trips on separate permission forms.

Also included below is the HYG Covenant. The Covenant is required for participation in HYG. Youth may be reminded of their commitment and asked to sign trip-specific Covenants for overnight trips with HYG.

This form is due October 6th.

First Name *

Last Name *

Phone Number *

School Name *

Date of Birth *

Streeth Address *

City, State, Zip *

Home Phone

Parent/Guardian Full Name *

Parent/Guardian Cell Number *

2nd Parent/Guardian Full Name

2nd Parent/Guardian Cell Number

Emergency Contact Full Name *

Emergency Contact Number *

Permission to Publish Photos *

In order to share the good news of the ministries of Hancock Church, we sometimes take photos of children and youth for use on bulletin boards, in our newsletters, and on our website. When published on our website and in weekly e-mails, we do not include any identifying information about the child along with the photo.

Yes, I do authorize Hancock Church to use and publish photos of my youth (named above) in the various church communications described above.

No, I do not authorize Hancock Church to use photographs of my child.

Required

Medical and Health Insurance Information

Youth's Doctor Full Name *

Youth's Doctor Phone Number *

Health Insurance Company Name *

Health Insurance Policy Number *

Does your child have any health concerns, physical limitations, or allergies that we need to know about? Please describe below.

In case of Emergency *

I understand that every effort will be made to contact parents/guardians in the event of an emergency. In an emergency requiring medical care and treatment, I authorize any physician, hospital, or other healthcare provider to give care to the above-named youth attending this trip. I also give permission for the transport to/from a doctor and/or hospital by a chaperone or ambulance.

Yes

Required

HYG Covenant

I covenant with my God and my fellow Hancock Youth Group members to be open to the surprising work of God in HYG, even when it comes through the unexpected (like bad food, exhausting work, or people who are very different from me). I will live as a part of this Christian community, showing respect and attentive love to each person in our group.

As part of HYG, I will seek to follow the example of Jesus who did not come to be served, but to serve. I will participate in all activities that have been planned for me, including any assigned work or chores. I will be hospitable to strangers.

I will avoid actions or attitudes that might detract from the building of Christian community or the mission we have been sent to accomplish (such as complaint, gossip, profanity, making fun of or excluding other, etc.). I understand that there will be absolutely no tolerance of the use or possession of alcohol, tobacco, drugs, or weapons, including, but not limited to, cigarette lighters and knives.

I will honor the adults who have so graciously given their time in order that HYG and all of our fun activities might happen. I will respect and obey them without challenge or complaint because I know that they love me and always have my best interests in mind. I will also listen to my elected HYG officers.

I will not destroy or take any property that does not belong to me, but I will instead leave things better than they were before I arrived.

While we are together, I will put my romantic relationships on hold, directing my full attention and energy for spiritual growth, community building, and the mission we have been sent to accomplish. I will refrain from any and all sexual activity, including, but not limited to, any public or private displays of romantic affection at HYG meetings, events, activities and trips.

I will honor the group and the importance of the time we have together by living within these basic behavioral guidelines for the trip:

I will be ready and on time for all activities.
I will not wander off from the group, and will stay with at least two friends, being careful that an adult always knows where I am.
I will let girls’ bedrooms be for girls only, and boys’ bedrooms be for boys only on any overnight trips.
I will obey the assigned “lights out” instructions at Grotonwood and in Kentucky.
I will only use my cell phone for purposes related to the trip or to communicate with my family.

In the event that I choose to break this Covenant, I understand that I may be sent home. If we are on a trip, this may be prior to the trip’s end at my parents’ expense. This decision will be made by the ministers on the trip in consultation with the adult chaperones.

I agree to abide by the HYG Covenant *

Yes

Required

This Covenant is committed to by: *

Youth Signature

This Covenant is also committed to by: *

Parent/Guardian signature

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