KINGDOM WEEK VOLUNTEER APPLICATION

KINGDOM WEEK PARTICIPANT APPLICATION
Participants*
Participating Church
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Days Planning to Attend

MondayTuesdayWednesdayThursdayFriday
Meals: Please note that we do not have gluten free options available with our meals. We would ask that you please plan accordingly.
EMERGENCY CONTACT*
RELATIONSHIP TO PARTICIPANT
EMERGENCY CONTACT PHONE*
ALLERGIES*
OTHER MEDICAL CONCERNS
Note: All participants over age 18 are required to have clearances on file either at their home church or with Mt. Carmel
Note: Participant fees cover all meals, painting equipment, and Kingdom Week T-shirt. The participant fees are collected by the

Suggested amounts are $50/if participating 5 days, $40/4 days, $30/ 3 days, $20/1-2 days.

FOR MINORS PARTICIPATING: In case of Emergency: I understand that every effort will be made to contact me. If can not be reached I hereby give the leaders of Kingdom Week mission teams permission to act on my behalf in seeking medical attention for my child in the event that such treatment is deemed necessary. I give permission for those administering emergency treatment to do so, using those methods deemed necessary. I absolve Mt Carmel EPC and its' Kingdom Week Team Leaders from liability in acting on my behalf.

I give my permission for Mt Carmel Evangelical Presbyterian Church to use photo images of my child on all of the following but not limited to: website, social media, slideshows etc.
HEALTH INSURANCE PROVIDER
INSURANCE GROUP OR MEMBER #
SIGNATURE OF PARENT OR GUARDIAN

Clear
DATE

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KINGDOM WEEK PARTICIPANT APPLICATION