Landmark 2009 Form Packet

8/14/2019 Landmark 2009 Form Packet

1/9

LANDMARK CHRISTIAN SCHOOL////FRONTLINE MISSIONSHONDURAS MISSIONS TEAM APPLICATION

Team Destination: Olanchito,Honduras2009 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, 2008If 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 separatesheet please)

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

14. Two personal references stating personal Christian character and conduct from1) 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


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SUPPORT LETTER GUIDELINESFor 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, Weencourage 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, oroutlining biblical passages.

3. Do use one or two verses that are appropriate to what the Lord is teaching you anddoing in your life. Verses that support what you are trusting the Lord to teach youare 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 designatedfrom 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 anote 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.


3/9

Details for Landmark Christian Schools Mission Trip toHonduras 2009

Date: April 3 - April 11, 2009Location: Olanchito, HondurasMinistry Focus: Drilling a well for water

Medical Clinics in remote villagesMedical/Dental in local villagesMinistry

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 3-13-08It is important that Frontline Missions has credited to youraccount a total of $825 by 2-13-09 and a total of $1,600 by3-13-09.


4/9

Dear

I am writing to share some exciting news with you regarding an opportunity to share themessage of the Gospel. This Spring break, I am joining with a group of high schoolstudents 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 April3rd for a nine-day trip focused on evangelism while performing free medical/dentalclinics in this nation. The people of Honduras are very open to the Gospel. The pastyears, Landmark Christian School was instrumental in planting new churches and seeinghundreds of people come to the Lord.

In preparation for departure, I am seeking support, both financially and in prayer. I needto raise $1,600 to make my trip possible. Will you consider a gift of $100, $50 or $25 ormore to make my dream a reality? There are so many people who have not heard theGood News of Christ, and I will have the chance to share the message of His love as wegive 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. Isincerely appreciate your prayerful consideration in helping make my mission trippossible.

Sincerely,

P>S> If you have any question about the short-term mission trip, please feel free tocontact me at . I thank you so much for your faithful prayers and financialsupport. Please make checks out to Frontline Missions with an attached note with myname 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 FormRelease 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 childis 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 beincurred by the undersigned and the child-participant that occur while said child is participating in the above-described 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 activitiesrelating 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 thenegligent, 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 forhim (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 ormedical 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, disciplinaryaction or otherwise, we (I) hereby assume all transportation costs.

Pastor's telephone_____________________Hospital insurance?: Yes: No:

Insurance company_____________________Policy number ________________________Physician___________________________ Physician's phone _____________________

Emergency phone numbers _________________________________________________ Participant may be the only signer if 18 years ofage or older. If under 18, both parents must sign.

_______________________________________

Father Date

____________________________ Mother Date

____________________________ Legal guardian Date

____________________________ Participant Date

NOTARY:

Sworn to me before this _______ day of __________________ 19____

Signed__________________________________________________

My Commission Expires on___________________________________


6/9

FRONTLINE MISSIONSHEALTH FORM

(Confidential)Please print in ink ortype. 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 ofcancer, tuberculosis, epilepsy, alcoholism, mental disorder, migraine headaches, asthma, diabetes,heart or any circulatory or blood disease? Specify relative and disease:__________________________________________________________________________________

Condition of health: Poor Fair Good ExcellentHeight: _____________Weight: _____________

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 High Blood Pressure Chronic Fatigue Obsessive Thoughts Respiratory Disorders Diabetes Endometriosis Compulsive Actions Epilepsy Mitral Valve Prolapse Pre-Menstrual Syndrome Depression Fainting Spells Cardiac Problems Sexually Transmitted Diseases Anxiety Problems Convulsions Stomach Ulcers AIDS Virus Bipolar Disorder Tic Problems Rheumatic Fever Anorexia Nervosa Night Terrors Leukemia Tuberculosis Bulimia Nervosa Psychiatric Consult. Cancer Lupus Speech Problems Substance Abuse Hepatitis Thyroid Problems Learning Disabilities Alcoholism Hypoglycemia Back Problems Sleep Difficulties Drug Flashback Anemia Incapacitating Headaches Att. Deficit/Hyperact. Disorder Females Only: Irregular periodsSevere Cramps Are you pregnant

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


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Medical History:Have you ever been turned down for medical reasons from any of the following: Life Insurance Military Employment CollegeHow 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 depressedAny lack of emotional control? Yes No Explain: ________________________________________________________________________________________________________________________

Do you suffer from insomnia? Yes No Disturbed sleep? Yes NoExplain: _____________________________________________________________________________

Have you ever seriously considered committing suicide? Yes NoIf 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/oremotional problems that currently affect you.

I certify that I have answered the above questions fully and honestly and that I have no othersignificant health problems.

Signed: ____________________________________________Date: ________________________________________________________________

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


8/9

AFFIDAVIT FOR TRAVELING WITH ADULT OTHER THAN PARENTDECLARACIN JURADA PARA VIAJAR CON ADULTO CON EXCEPCIN 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 ________________ TOQUE NACI ENCENDIDO

ACCOMPANY Alan Winter AND/OR Heidi Winter AND/OR Harry Calsbeek AND/ORMolly Worrell

PARA ACOMPAAR

______________________________ON A TRIP OUT OF THE UNITED STATES TOEN UN VIAJE FUERA DE LOS ESTADOS UNIDOS

HONDURAS, FROM April 3, 2009 THROUGH April 11, 2009. THIS ISA HONDURAS, Abril 3, 2009 Abril 11, 2009.

ALSO OUR PERMISSION FOR MEDICAL ASSISTANCE TO BE ADMINISTERED SHOULDTHEY BECOME ILL OR INVOLVED IN AN ACCIDENT.

STE ES TAMBIN NUESTRO PERMISO PARA QUE LA AYUDA MDICA SEAADMINISTRADA SI LLEGAN A ESTAR ENFERMOS O IMPLICADOS EN UN ACCIDENTE.

_____________________________Father/Padre Date/Fecha

_____________________________Mother/Madre Date/Fecha

_____________________________Legal guardian/Guarda legal Date/Fecha

___________________________ ______________NOTARY SEAL AND SIGNATURE DATE/FECHASELLO Y FIRMA DE NOTARIO

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


9/9

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 bag2. Place all items in large zip lock bags for easy access and dryness

Pre-Departure

Passport Turn in to Harry or LandmarkFront desk by March 21, 2009 Spending Money Minimum $50Carry-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 AttitudeBasics 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 VitaminsToiletries Comb / Brush Toothbrush / Paste Dental Floss Deodorant Skin Care Lotions / Creams Small Shampoo - Hotels dont 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 BagsOptional 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

Documents

Landmark 2009 Form Packet