ServeWeek Extravaganza 2021
Hope Community Church | Gilbertsville, PA
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STUDENT INFO
Please fill out a separate survey for each student attending. Thank you!
Student Last Name *
Student First Name *
Student Full Address *
Current Grade (2020/2021 school year) *
Allergies *
List any of your student's allergies
Student Tshirt Size *
PARENT/GUARDIAN INFO
Parent/Guardian Full Name *
Parent/Guardian Relationship to Student *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
2nd PARENT/GUARDIAN INFO (optional)
2nd Parent/Guardian Full Name (optional)
2nd Parent/Guardian Relationship to Student (optional)
2nd Parent/Guardian Email Address (optional)
2nd Parent/Guardian Phone Number (optional)
SERVEWEEK EXTRAVAGANZA REGISTRATION
Throughout this service week, we will be serving in our church and community. We will stay overnight in the church building.
The cost for ServeWeek Extravaganza, including food and travel, is (high school $120, middle school $100). A $60 deposit is due May 9th, and the final balance is due June 6th.  Click the box stating you agree to these dates and costs. *
Make all checks payable to Hope Community Church.
Required
All paperwork and payments go in the Youth Box located inside the Hub (pictured below), or they can be mailed directly to HCC (2732 N. Charlotte St. Gilbertsville, PA 19525)
Student Trust Fund Account *
By checking the box below, I agree that any money that my teen has in their Student Trust Fund Account will be applied to my balance due.
Required
Would you like to discuss a scholarship option for your student to help toward the total cost of ServeWeek Extravaganza with Pastor Kyle? *
Minor Release Form *
A current 2020-2021 HSM Minor Release Form is mandatory for this trip. If you have not yet filled one out for your student, please do so and hand one in. You can click the link below to download the form or find it on the church website teen page.  https://90eb2ad3-b7f8-440c-a4b5-d7c5e1632dcb.filesusr.com/ugd/9bc3cf_7ae86106454c4e659bf15960a6235da9.pdf
Insurance Card *
A copy of the front & back of your Insurance Card needs to be handed in along with your Minor Release Form.
COVID Release Form *
A current COVID Release Form is required in order for your student to attend ServeWeek Extravaganza. You can click the link below or find it on the church website teen summer trips page. https://90eb2ad3-b7f8-440c-a4b5-d7c5e1632dcb.filesusr.com/ugd/9bc3cf_238174fe907248b3b508cd8e7e559d3c.pdf
VBS Day Camp Registration *
In the mornings, we will serve at Vacation Bible School Day Camp at our church. You must sign up your student to serve at VBS so the VBS Leadership Team has all the necessary information as they direct the week.  You can use the following link to  register your student as a VBS Volunteer or also find it on the church website teen summer trips page. https://docs.google.com/forms/d/e/1FAIpQLScpdjiC3CFjEd5Yvn_5AVbRpOXZg3li4hVUXHrw4RTRGOG75g/viewform
Required
Additional Forms / Background Checks *
Once you have completed the 2021 VBS Volunteer Sign Up if your student is 18 years of age and older, our church Admin, Sharon Gery, will be contacting you regarding your HCC Volunteer Forms & PA Clearances.  In an effort to stay compliant with PA state regulations, these forms will need to be completed by all adult volunteers 18 years of age and older.
Required
Do you need a T-Shirt? *
Students are required to wear an HSM or HOPE COMMUNITY CHURCH T-Shirt each day at VBS. All students will receive one free T-shirt for this event. Additional T-shirts will be available for purchase in late spring, and you can order one when you register your student as a VBS volunteer.
REGISTRATION AGREEMENT
By completing & submitting this form you are agreeing to pay for the entire cost (high school $120, middle school $100) for ServeWeek Extravaganza 2021 trip. Final balances are due June 6, 2021. After May 9th, we will NOT be able to refund any payments.  If your student cannot attend, please inform Pastor Kyle in writing by May 9th. REFUNDS WILL ONLY BE GIVEN AFTER MAY 9TH IF YOUR STUDENT CANNOT ATTEND DUE TO HAVING COVID OR BEING EXPOSED TO COVID.
I, the parent/guardian of the student listed agree to the statement above. (type name below) *
Today's Date *
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