Crestview Student Ministry Crestview Baptist Church Georgetown, TX
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1 Crestview Student Ministry Crestview Baptist Church Georgetown, TX Dear Parent/Guardian, This packet is to inform you of an upcoming event that can spiritually grow your student(s): Disciple Now on February 15 th -17 th. The purpose of D-Now is for your student(s) to have all of the benefits of getting away with little cost or hassle. This is an in-town weekend retreat where your student(s) spends time bonding with other students, growing deeper in their faith, and learning how to be disciples for Christ. Students will spend the weekend (Friday to Sunday) in the homes of church members in groups according to age and gender with adult leaders who are spiritually mature. They will participate in small group studies, church recreation, and other unique activities. The cost for the weekend is $60 per student. If money is an issue please contact Josh Williford or visit peoplesharingjesus.com/students/ and scroll down to the CSM Scholarship Application, fill out the form, and return it to We are excited and honored to be allowed to care for your student(s)! Their overall safety will be our first concern. We have a number of adults that will be around all weekend to care for and simply love your student(s). Please call Josh Williford ( ) or (josh@peoplesharingjesus.com) him if you have any questions. We will be praying for you and your student(s). In Christ s Love, Josh Williford Student Minister Crestview Baptist Church
2 Disciple Now 2019 Join Crestview Baptist Church Student Ministry as we spend a weekend looking at being FEARLESS and the power that allows us to do so! D-NOW is what we wish all weekends could be: filled with friends, fun, and fellowship! You ll learn and be loved on. You will experience and engage in awesome worship! And you will grow big time in small groups led by some amazing leaders! Who: What: When: All Middle School & High School Students (Those currently in 6 th Grade to 12 th Grade) In-town retreat: Experience fellowshipping with others in our community, having fun, making friends, and be lead in the worship/teaching from God s Word! February 15-February 17, 2019 (A three day, two night overnight stay at an area Host Home.) Where: Crestview Baptist Church 2300 Williams Dr. Georgetown, TX Cost: $60.00 per Student. *Paperwork and registration fee must be submitted to reserve a shirt by January What to Bring: What NOT to Bring: Itinerary: Bible, Pen/Journal, Water bottle, Clothing for three days, Bath towel & Hygiene kit, Bedding (sleeping bag / sheets /blankets/pillow), Jacket/Raincoat and sturdy tennis shoes. Cell phones, ipods, Laptops, ipads, ereaders, radios, tobacco, knives, guns, gaming systems, etc. Anything found will be taken up and returned after the event is over. If a student neglects to follow these rules and refuses to abide by these rules they will be asked to leave the event. Cell phones will be taken up if seen. Students will ALWAYS be with an adult who has a cell phone for emergencies; therefore there is no need for students to bring their own. If they do bring a cell phone, please stress that it be put away and not used unless absolutely necessary. Check-in begins at 6:30 pm on Friday, February 15, Students will end the weekend by gathering at Crestview Baptist Church at 8:00am on Sunday morning, February 17, The event will not end until 12:00pm on Sunday.
3 DISCIPLE NOW 2019 SUGGESTED SCHEDULE We reserve the right to do the youth thing and make time changes if absolutely necessary (i.e. It being a decisive factor in World Peace; a van has a flat; etc ) Friday February 15 6:30pm 7:00pm 9:00pm 11:30pm Check-In Kick-Off Event!! Large Group Session Group Host Homes Lights Out Saturday February 16 8:00am 8:20am Church Large Group Session 9:30am Facing Fears Frenzy (Part 1) 12:00pm Lunch 12:30pm Facing Fears Frenzy (Part 2) 2:00pm 4:00pm 4:45pm 6:15pm 6:40pm 9:00pm 10:00pm 11:30pm Clean Host Homes Arrive at Secret Location Large Group Session Dinner Special Event Small Group Time Special Worship Lights Host Homes Sunday February 17 8:00am 9:30am 11:00am 12:00pm Church Large Group Session Group Time Go Home!
4 Covenant of Conduct (You Must Sign Covenant to Attend) In all meetings, retreats or other events under the sponsorship and/or guidance of Crestview Baptist Church, I am representing the Christian community and I am responsible for my actions. I agree to the following guidelines: 1. The use or possession of illegal drugs, alcoholic beverages and tobacco are prohibited. 2. All conduct shall be in keeping with the highest Christian regard and respect for all persons. 3. All dress shall be in good taste and in accordance with the dress requested for the Church event. 4. All individuals are expected to join in group activities. 5. No profanity, sexually inappropriate behavior or PDA (Public Display of Affection). 6. No Pranks! 7. You are a guest in the home of your host family. Please be responsive to their requests and suggestions. Keep all food in designated areas. Not sure where to eat?? Ask your host. Limit showers to 5 minutes or less! 8. You will need to show your leader full respect and cooperation, and participate in each session of D-Now, including meals and study sessions. 9. You will not be allowed to leave your D-Now home unless previously arranged with Josh Williford. Your group needs you, and for you to get the most of the weekend, you need to be present. 10. Please be responsive to God s Spirit throughout the weekend. Do not miss out on the things He wants to do in your life! I, the below named Youth, understand the above Covenant of Conduct, and I agree to abide by it. Student Signature: We (I) as parents (guardians) understand this agreement. If the Youth disregards the Covenant of Conduct, a serious attempt to contact all the given phone numbers will be made and plans to pick up the Youth will be arranged. If we (I) are unavailable for contact or refuse to pick up the Youth, the current most available transportation carrier will be used (at parents/guardians expense) to return the Youth home. Please do not bring your cell phones, IPod's, any other electronic devices and/or valuables to Crestview Baptist Church. Crestview Baptist Church and its staff members/volunteers are not responsible for any lost, damaged or stolen property. Sign below to acknowledge this policy. Signature of Parent or Legal Guardian Date Student s Name Printed: T-Shirt Size: Current Grade: Gender:
5 Phone (512) Fax ( peoplesharingjesus.com/students/ Crestview Student Ministry 2019 STUDENT INFORMATION & MEDICAL RELEASE FORM Crestview Baptist Church Georgetown, TX Josh Williford: Name of Student: Last First Middle Name Used Birth Date: / / Age: Current Grade: Gender: M F Shirt Size: Address: Street City Zip Home Phone: ( ) Cell Phone: ( ) Mother/Legal Guardian: Mother s Cell Phone: ( ) Business Phone: ( ) Father/Legal Guardian: Father s Cell Phone: ( ) Business Phone: ( ) Please See Back of Form If parent/legal guardian not available during an emergency, notify: Name: Relationship to Student: Home Phone: ( ) Additional Number: ( ) MEDICAL INFORMATION: In the event of an accident or special health needs, it will be necessary to have the requested information. Please provide thorough and accurate medical information. Family Physician: Address: Phone: ( ) Please list any allergies: Does student have any medical /health problems, any recurring illness or illnesses that would have any effect on participation in any activities? If so, please list: My student may be allowed to be given to take the following over-the-counter medication(s): Medication: Purpose (e.g. allergies, asthma, antibiotic) Dosage (amount to be given): How often or at what time: Remarks or special instructions: My Student has year-round prescription medications and they are: Medication: Purpose (e.g. allergies, asthma, antibiotic) Dosage (amount to be given): How often or at what time: Remarks or special instructions: Please See Back of Form Medication: Purpose (e.g. allergies, asthma, antibiotic) Dosage (amount to be given): How often or at what time: Remarks or special instructions:
6 STUDENT INFO / MED REL 2019 MEDICAL INSURANCE INFORMATION: Insurance Company: Plan or Group #: Ins/ Co. Phone: ( ) Name of Policy Holder: (It is recommended that you attach a photocopy of your family medical insurance card.) I understand that Crestview Baptist Church, Georgetown, TX carries limited medical or hospitalization coverage in the event of an accident. I, also, understand that in the event that this student needs medical attention while in route to or while participating in a CBC Student Ministry sponsored function, by signing below I give permission for the Crestview Baptist Church Student Ministry Department of Georgetown, Texas adult sponsors to seek any necessary medical attention. I understand that I will be notified as soon as reasonably possible in such a case. Furthermore, I will not hold Crestview Baptist Church, Georgetown, Texas or its adult sponsors liable for any accident that the above named student may incur while attending a CBC Student Ministry activity. I understand that, in some cases, students may travel in the private vehicles of adult sponsors due to transportation shortages. All driving sponsors will be at least 21 years of age and possess a valid Texas Drivers License. I understand that it is my responsibility to notify the Student Minister and the above named student if I do not want the student riding in a private vehicle. To the best of my knowledge, I have accurately completed the above form in good faith. My student has permission to participate in Crestview Student Ministry activities. I will notify the Student Ministry office of any address, telephone, emergency or insurance changes, if applicable, if and when changes occur. Signature of Parent /Guardian: Date: I hereby give Crestview Baptist Church, Georgetown, TX permission to publish any or all pictures and/or videos of my son/daughter as a participant in their activities. Signature of Parent /Guardian: Date: THIS FORM IS EFFECTIVE FROM SIGN DATE THROUGH THE END OF THAT SAME YEAR. A NEW FORM MUST BE OBTAINED EACH YEAR.
7 Prescription Medication Administration Form This form is to be completed and submitted for each trip with CSM along with below described medications. Student s Name: Birthdate: / / Age: Sex: Male Female As the parent or legal guardian of the above-named child, I give my permission to the enlisted Crestview Student Ministry to administer as prescribed by law the listed below medication to my child. ( ) ( ) Parents/Guardian Signature Date Daytime Phone # Evening Phone # For Prescription Medications only...please follow these guidelines: In accordance with Texas Department of Health regulations: ALL Medication that is brought must be: (1) Placed in the care of a CSM Adult worker, (2) Prescribed for the student (not a sibling or parent), (3) In the original container with all labels intact, and (4) Correct current dosage clearly marked. Dosage of non-prescription medication may not exceed product recommendation without doctor s written orders. CSM requests that you do not send over-the-counter medications (i.e. Tylenol, Ibuprofen, Benadryl, etc.) unless consistently needed by student. If necessary, make additional copies of this blank Medication Form in order to provide requested information for each medication. All Medication Release/Administration Forms and medication(s) to be administered should be given to CSM Adult Workers. The Forms will be reviewed to clear up any possible questions about medications or their administration. To make it easier the parent/or student should put their medications and forms in a zip-lock type plastic bag with the student s name written with a marker on the outside of the bag. Parents should emphasis to their student the responsibility of reporting for their medications while with CSM Cut here and place forms in zip-lock type bags with medication Name of Medication: Purpose for medication use (e.g. allergies, asthma, antibiotic) Form of medication: Tablet Pill Capsule Liquid Inhalation Other (specify) Dosage (amount to be given): How often or at what time: Remarks or special instructions: Name of Medication: Purpose for medication use (e.g. allergies, asthma, antibiotic) Form of medication: Tablet Pill Capsule Liquid Inhalation Other (specify) Dosage (amount to be given): How often or at what time: Remarks or special instructions: Name of Medication: Purpose for medication use (e.g. allergies, asthma, antibiotic) Form of medication: Tablet Pill Capsule Liquid Inhalation Other (specify) Dosage (amount to be given): How often or at what time: Remarks or special instructions:
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