Landmark 2009 Form Packet

LANDMARK CHRISTIAN SCHOOL /FRONTLINE MISSIONS

HONDURAS MISSIONS TEAM APPLICATION Team Destination: Olanchito, Honduras 2009 Spring Break - April 3rd – 11th, 2009 Cost of Trip - $1,600 ** (will be reduced if cheaper airline tickets can be secured) Personal Information 1.

Name (as on passport/birth certificate): ___________________________________

2.

Address: _____________________________________________________________ City: ________________________ State: _____________ Zip: __________________ Phone Number: (____) ____-________ E-Mail _______________________________

3.

Date of Birth: _______________ Country of Birth: ____________________________

4.

Passport Number: __________________________ Expiration Date: ______________

5.

Emergency Contact: ______________________________ Phone: ________________

6.

Occupation ________Student________ Employer/School: Landmark Christian School

7.

Marital Status: ______Single __ Church: ____________________________________ T-Shirt Size: ________________

Delta Sky Miles Number ___________________ Skills

8.

Language Skills Other Than English: _______________________________________

9.

Please List Any Professional, Business, Trade or Ministry Skills (including the arts): ______________________________________________________________________

10.

Have you been on a mission trip before? ______

Where? _____________________

With Whom? ________________________________ When? _____________________ Please Supply The Following:

11. $200 deposit due by December 12, 2008 If you have been with Frontline Missions in the past year questions 12-14 are not needed. 12.

A written statement on why you want to go on this mission trip. (On back or separate sheet please)

13.

Please describe the strengths and talents that you will be attributing to the team. (On back or separate sheet please)

14.

Two personal references stating personal Christian character and conduct from 1) Teacher or Coach 2) Pastor or a Leader from your church

FOR QUESTIONS OR ADDITIONAL INFORMATION PLEASE CONTACT: 1. MR. TITUS AT LANDMARK CHRISTIAN SCHOOL – [email protected] or 2. FRONTLINE MISSIONS – [email protected] or call 770-774-0641

SUPPORT LETTER GUIDELINES For writing your letter

To raise prayer support for your ministry and financial support as the Lord provides. 1. Do make your letter personal. Be yourself in your writing expression, We encourage you to write why you are going and what you hope to see God do in and through you. 2. Do make it spiritual, but please be sensitive. Avoid preaching, sermonizing, or outlining biblical passages. 3. Do use one or two verses that are appropriate to what the Lord is teaching you and doing in your life. Verses that support what you are trusting the Lord to teach you are good. 4. Do be specific and try to limit the letter to one page. 5. Do check your grammar, spelling, and punctuation. Have someone proof your letter. 6. Do make the letter appealing to the eye, original, and easy to read. Artwork, headings, and space will help the reader understand the message. 7. Do find out where the checks need to be sent and how they should be designated from your church and/or agency. 8. Do mention your financial need. Example: “The cost of this mission trip will be $1,500 if your feel the Lord leading you to share in this ministry, you can make check payable to Frontline Missions and enclose a note designation to your name/name of mission trip i.e. Johnny Smith – Landmark 2009 9. Do mention the date by which you need your support to be raised. 10. Do mention where to send support, checks should be mailed to you. 11. Do remember to include your return address on your prayer letter. 12. Do make a copy of the letter for your team leader. 13. Do start meeting weekly for prayer with a partner or another team member.

Details for Landmark Christian School’s Mission Trip to Honduras 2009 Date: April 3 - April 11, 2009 Location: Olanchito, Honduras Ministry Focus: Drilling a well for water Medical Clinics in remote villages Medical/Dental in local villages Ministry Total cost: $1,600 due by 3/14/07 $200 non-refundable deposit 12-05-08 $625 more by 2-13-09; and the remaining $775 by 3-13-08 It is important that Frontline Missions has credited to your account a total of $825 by 2-13-09 and a total of $1,600 by 3-13-09.

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> Dear <> I am writing to share some exciting news with you regarding an opportunity to share the message of the Gospel. This Spring break, I am joining with a group of high school students from my school to travel to Honduras for a short-term missionary trip. We, the youth and adult team from Landmark Christian School, will be leaving on April 3rd for a nine-day trip focused on evangelism while performing free medical/dental clinics in this nation. The people of Honduras are very open to the Gospel. The past years, Landmark Christian School was instrumental in planting new churches and seeing hundreds of people come to the Lord. In preparation for departure, I am seeking support, both financially and in prayer. I need to raise $1,600 to make my trip possible. Will you consider a gift of $100, $50 or $25 or more to make my dream a reality? There are so many people who have not heard the Good News of Christ, and I will have the chance to share the message of His love as we give out the medical care. What a responsibility, but also what a privilege! I appreciate your consideration of support. Included is a return envelope for your use. I sincerely appreciate your prayerful consideration in helping make my mission trip possible. Sincerely, <> P>S> If you have any question about the short-term mission trip, please feel free to contact me at <>. I thank you so much for your faithful prayers and financial support. Please make checks out to Frontline Missions with an attached note with my name and LCS Honduras 2009 on it. Please leave the memo line blank on your check. Send this to my address please: <> <

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FRONTLINE MISSIONS Liability Release/Consent Form Release of All Claims Name of participant ________________________ Age ________ Birthdate _______________ Address __________________________________ Phone (_____)________________________ City ______________ State _____ Zip code ________ Social Security #______________________ Parent(s) business phone __________________________ ________________________________ In consideration for being accepted by Frontline Missions for participation on a Mission Trip, we (I), being 18 years of age or older, do for ourselves (myself) (and for and on behalf of my child-participant if said child is not 18 years of age or older) do hereby release, forever discharge and agree to hold harmless Frontline Missions, Landmark Christian School and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in the abovedescribed trip or activity. Furthermore, we (I) [and on behalf of our (my) child-participant if under the age of 18 years] hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in all activities relating to the Mission Trip. Further, authorization and permission is hereby given to said mission to furnish any necessary transportation, food and lodging for this participant. The undersigned further hereby agree to hold harmless and indemnify said church and/or mission, its directors, employees and agents, for any liability sustained by said church and/or mission as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto. (If the participant has not attained the age of 18 years): We (I) are the parent(s) or legal guardian(s) of this participant, and hereby grant our (my) permission for him (her) to participate fully in said trip, and hereby give our (my) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, we (I) hereby assume all transportation costs. Pastor's telephone_____________________ _______________________________________ Hospital insurance?: Yes: No: Date Insurance company_____________________ Father Policy number ________________________ ____________________________ Physician___________________________ Mother Date Physician's phone _____________________ Emergency phone numbers _______________

__________________________________ Participant may be the only signer if 18 years of age or older. If under 18, both parents must sign.

____________________________ Legal guardian

Date

____________________________ Participant

NOTARY: Sworn to me before this _______ day of __________________ 19____ Signed__________________________________________________ My Commission Expires on___________________________________

Date

FRONTLINE MISSIONS HEALTH FORM (Confidential) Please print in ink or type. Couples should fill out separate forms.

________________________________________ Name: _____________________________________ Age: ___________Date: _______________ Current Marital Status: Single Married Divorced Widowed

________________________________________ Heredity: Among your immediate family, grandparents, uncles or aunts, is there any history of cancer, tuberculosis, epilepsy, alcoholism, mental disorder, migraine headaches, asthma, diabetes, heart or any circulatory or blood disease? Specify relative and disease: __________________________________________________________________________________ Condition of health: Poor Height: _____________ Weight: _____________

Fair

Good

Excellent

Immunizations: To your knowledge, which of the following have you had the normal immunizations for? Mumps Rubella Cholera Tetanus Typhoid Pertussis Measles Hepatitis A Hepatitis B Diphtheria Polio Others: ___________________________ Allergies: Specify if you have any allergies (to medications, food, or other): __________________________ __________________________________________________________________________________ __________________________________________________________________________________ Physical Conditions: Indicate whether you have or have had: (Also circle those that still apply to you now.) Asthma Respiratory Disorders Epilepsy Fainting Spells Convulsions Tic Problems Leukemia Cancer Hepatitis Hypoglycemia Anemia

High Blood Pressure Chronic Fatigue Diabetes Endometriosis Mitral Valve Prolapse Pre-Menstrual Syndrome Cardiac Problems Sexually Transmitted Diseases Stomach Ulcers AIDS Virus Rheumatic Fever Anorexia Nervosa Tuberculosis Bulimia Nervosa Lupus Speech Problems Thyroid Problems Learning Disabilities Back Problems Sleep Difficulties Incapacitating Headaches Att. Deficit/Hyperact. Disorder

Obsessive Thoughts Compulsive Actions Depression Anxiety Problems Bipolar Disorder Night Terrors Psychiatric Consult. Substance Abuse Alcoholism Drug Flashback

Females Only: Irregular periods Severe Cramps Are you pregnant

FRONTLINE MISSIONS
5600 SHORT RD.
FAIRBURN, GA. 30213
[email protected]
770-969-4941

Medical History: Have you ever been turned down for medical reasons from any of the following: Life Insurance Military Employment College How many days have you been hospitalized in the past five years for the following: Medical Surgical Psychiatric Explain: __________________ ____________________________________________________________________________________ Temperament: Indicate which characteristics seem to apply to your temperament: Impulsive High-strung Nervous Calm Easy-going Introspective Shy Anxious Moody Self-conscious Aggressive Dominant Optimistic Cheerful Enthusiastic Irritable Self-confidant Often depressed Any lack of emotional control? Yes No Explain: _____________________________________ ___________________________________________________________________________________ Do you suffer from insomnia? Yes No Disturbed sleep? Yes No Explain: _____________________________________________________________________________ Have you ever seriously considered committing suicide? Yes No If so, when?_________________ Stamina: Is there any reason why you cannot tolerate: Rigorous outdoor activity? High altitudes? High temperatures? Low temperatures? Explain: _____________________________________________________________________________ ____________________________________________________________________________________ Do you have any handicaps which might hinder missionary service? Explain: ____________________________________________________________________________________ Are you on any type of special diet? Explain: _______________________________________________ ____________________________________________________________________________________ Other:

We need to have information from your physician regarding any significant medical and/or emotional problems that currently affect you. I certify that I have answered the above questions fully and honestly and that I have no other significant health problems. Signed: ____________________________________________Date: ______________________

__________________________________________

FRONTLINE MISSIONS
5600 SHORT RD.
FAIRBURN, GA. 30213
[email protected]
770-969-4941

AFFIDAVIT FOR TRAVELING WITH ADULT OTHER THAN PARENT DECLARACIÓN JURADA PARA VIAJAR CON ADULTO CON EXCEPCIÓN DE PADRE

TO WHOM IT MAY CONCERN: A QUIEN PUEDA INTERESAR: I, ______________________________, GIVE PERMISSION FOR MY SON\DAUGHTER, DOY, EL PERMISO PARA MI HIJO , WHO WAS BORN ON ________________ TO QUE NACIÓ ENCENDIDO ACCOMPANY Alan Winter AND/OR Heidi Winter AND/OR Harry Calsbeek AND/OR Molly Worrell PARA ACOMPAÑAR ______________________________ ON A TRIP OUT OF THE UNITED STATES TO EN UN VIAJE FUERA DE LOS ESTADOS UNIDOS HONDURAS, FROM April 3, 2009 THROUGH April 11, 2009. THIS IS A HONDURAS, Abril 3, 2009 – Abril 11, 2009. ALSO OUR PERMISSION FOR MEDICAL ASSISTANCE TO BE ADMINISTERED SHOULD THEY BECOME ILL OR INVOLVED IN AN ACCIDENT. ÉSTE ES TAMBIÉN NUESTRO PERMISO PARA QUE LA AYUDA MÉDICA SEA ADMINISTRADA SI LLEGAN A ESTAR ENFERMOS O IMPLICADOS EN UN ACCIDENTE.

_____________________________ Father/Padre

Date/Fecha

_____________________________ Mother/Madre

Date/Fecha

_____________________________ Legal guardian/Guarda legal

___________________________ NOTARY SEAL AND SIGNATURE SELLO Y FIRMA DE NOTARIO

Date/Fecha

______________ DATE/FECHA

NOTE: BOTH SIGNATURES NEEDED OR DIVORCE DECREE STATING SOLE CUSTODY. NOTA: FIRMAS NECESITADAS O DECRETO DEL DIVORCIO QUE INDICA CUSTODIA Única.

Packing Checklist **Packing Notes: Due to the chances of rain or wet ground, please pack as follows: 1. Line your suitcase or duffle bag with an extra large, heavy duty yard/garbage bag 2. Place all items in large zip lock bags for easy access and dryness Pre-Departure Passport – Turn in to Harry or Landmark Front desk by March 21, 2009 Spending Money – Minimum $50 Carry-on List Book Bag or Backpack Extra clothes for 1 night - underwear - skirt for girls - sweatshirt Toiletries - Liquids, Gels, & Creams - not bigger than 3 oz - packed in qt. zip lock Snacks Prescriptions Bible Travel Journal & Pens Sunglasses A Positive Attitude Basics Personal Duffle Bag or Suitcase Travel Clothing – Team shirt provided Travel Footwear – airport security Daily Clothing - Hiking footwear - Boys - Pants - Girls – Skirts - 1 light long sleeved shirt for dusk and dawn bugs - T-shirts - Shorts - non-ministry times Bathing Suit Visor or Brimmed hat Light Poncho for rain Language Books Address Book including all your supporters Water Bottle or Camel Back Small Pillow if desired

Medication Contact Lens Preparation Insect Repellent non-aerosol Sunscreen Sunburn Relief Motion Sickness Medicine Personal Hygiene Items Personal Prescriptions Vitamins Toiletries Comb / Brush Toothbrush / Paste Dental Floss Deodorant Skin Care Lotions / Creams Small Shampoo - Hotels don’t provide Towelettes or Wet Wipes Toilet Paper Antibacterial waterless soap Shaving Cream 2 Quik Dry Towels for beach & daily use flip Flops (for shower use) Maintenance Items Flashlight Batteries / Bulb Camera Batteries Mesh Bag for Dirty Laundry Zipclose Plastic Bags Optional Items Ear Plugs (in case roommate snores) Mini Sewing / Repair Kit Duct Tape Clothes Line & Pins Pocket Knife – check-in luggage only Snacks Powdered Propel to add to water for hydration Throat Lozenges