Hands Across the Border UMVIM Mission Trip Matamoros by uqy23753


									          Hands Across the Border UMVIM Mission Trip
                      Matamoros, Mexico
                 August 28 - September 1, 2008
Thanks for your interest in this mission trip. Just follow the easy steps below and you’re
on your way to a great experience!
   • Fill out the enclosed registration packet completely. Two of the forms need to be
       notarized. If you know a notary, please feel free to have this taken care of. If not,
       we will have a notary available at the Pre-Trip Meeting (see below) and you may
       have it notarized at that time.
   • Please know that the medical information will be kept confidential, in the
       possession of the Team Leader. It is important that you include all relevant
       medical information so that it would be available in the event of an emergency.
   • The General Board of Global Ministries Accident Insurance Policy covers
       accidents that occur both in and out of the US, as well as medical evacuation and
       repatriation. The cost of $.75 per day is covered in your registration fee.
   • The Notification of Death form is a precaution that is wise to carry at any time
       you travel outside of the US.
   • The last page of the packet is a Release of Liability from Juntos Servimos. This is
       the non-profit organization that handles the scheduling of mission trips for Larry
       Cox, the missionary we work with, and also purchases our project supplies. They
       want releases on everyone who registers with them.
   • Turn in the completed forms, as well as your $200 trip fee no later than August
       10. You may bring your forms and fee to the Wesley Mission Center, the main
       church office, or to the Mission Connection in the atrium on Sunday morning.
   • Attend the pre-trip meeting Tuesday, August 12 @ 7:00pm in Room 111 of
       the Main Building. Even if you have been on other trips, it is important to
       attend this meeting. You might also want to include your family at this meeting
       so that they can have a better understanding of what you will be doing and meet
       your team members!
   • If your Tetanus vaccination is not up to date, please take care of that. That is
       something we request for all mission trips.
   • Begin to prepare for the trip through prayer. God has done some truly remarkable
       things through these mission trips….invite Him to be in control of all our plans, to
       be at work in your life and in the lives of the people we will serve. This is an
       opportunity to give yourself completely in an act of servanthood and submission
       to God’s design. Begin now to prepare your heart and allow Him to use you.

      If you have any questions, concerns or thoughts, please call me
                             @ 817-473-6650.
Dios le bendiga!
(God bless you!)

Teresa Sherwood
Director of Mission Ministries
                           Hands Across the Border
                                Matamoros, Mexico
                            August 28 - September 1, 2008

Name ____________________________________ email: ________________________

Address        ___________________________________

Phone: __________________ (hm)
       __________________ (wk)                      cell: ________________________

Emergency Contact: _________________________Phone:______________________

Previous Mission Trip experience? ___________________________________________

Do you have any Spanish language skills? ___yes ___no
      Please rank on a scale of 1-10 (Ten being fluent) _____________

Do you have medical skills? _____yes ____no
      If yes, please describe: ______________________________________________

Please rate your proficiency in the following construction skills on a scale of 0-10 (Ten
being professional)
Concrete________ Framing ________ Roofing _________ Electrical _________
Plumbing _______ Sheetrock _______

Please check any of the following that interest you:
Children’s Activities _______        Music _______       Leading devotionals_______
Food Preparation ________            Photography _______

                                 Medical Information
                  (Please complete attached medical information form)
Do you have any physical limitations? ________________________________________
Allergic to: __________________        Date of last Tetanus shot: ___________________

                             Insurance Information
Insurance Company: ______________________________________________________
       Address: __________________________________________________________
       Policy # ___________________ Group # _______________________________
                       First United Methodist Church
                              Mansfield, Texas

                                  Mission Covenant

As a member of the First United Methodist Church Mission Team, I will abide by the
following covenant for the duration of the trip:

   1.      Familiarize myself with the customs, cultures and traditions of the country or
           region to which I will be traveling; respect all customs, cultures and traditions,
           and act in deference to such customs, cultures and traditions, which includes
           action or dress that will be offensive to the people of the country or region to
           which I am traveling as described by the team leader.
   2.      Respect the views and feelings of the other mission team members and those
           of the host community.
   3.      Refrain from all conduct that may reflect poorly on myself and my mission
           team, including consumption of alcoholic beverages, use of illegal drugs,
           gambling, possession of weapons of any kind, use of tobacco at the work site
           or host church, or use of profanity or offensive language.
   4.      Support the mission team leadership.
   5.      Attend and participate in all activities in preparation for the trip. While on the
           mission trip, attend and participate in all sharing sessions and devotions,
           contribute to team efforts, and share my experience when I return.
   6.      Be a true servant and representative of Christ, Christ’s Church and the United
           Methodist Church.

I understand that the team members must be flexible, cooperative and cheerful. I agree to
cooperate at all times with the team leader concerning our life together, including daily
assignments, food, lodging and transportation. I agree to stay with the team from
beginning to end, and to share my faith in an appropriate Christian manner.

Signature______________________________________               Date___________________
                                 What to Bring

Bedding (air mattress recommended, separate beds for each individual), pillow, sheets
       and/or blanket
Personal hygiene supplies
Modest sleepwear
Travel clothes
Clothes to wear in the evenings (you can re-wear these several times)
Work clothes (no shorts, no tank tops)
Clean pants or skirt for worship on Sunday
Work gloves
Work shoes (closed toes, 2 pair is a good idea)
Bug spray
Day pack
Personal medications (in original bottles, properly marked)
                          Money for travel meals, souvenirs, etc.

Personal Tools:
Nail apron, paint brush, pencil, hammer, tape measure, cement trowel, paint container.
Bring what you already have…don’t go out and get this stuff.

Please do not bring jewelry, other than a watch

Cards, dominoes, etc.
Medical and Liability Release Form
I___________________________________authorize___TERESA SHERWOOD______
        (UMVIM participant)                                 (another adult on trip)
If I am unable to do so, to consent to any necessary examination, anesthetic, medical
diagnosis, surgery treatment and/or hospital care rendered to me under the general or
special supervision and on the advice of any physician or surgeon licensed to practice
medicine by the state in which he/she practices, during the duration of the trip identified

Home Physician______________________________ Phone (      )________________
Medical Insurance Provider ____________________ Phone ( )_________________
Policy Number _________________________ Group Number ____________________
Allergies _______________________________________________________________
Medications ____________________________________________________________
Person In USA to contact in the event of an Emergency:
Name_____________________________________ Relationship _________________
Address________________________________________ Phone ( )____________
Blood Type_____ Do you have: Diabetes ___Yes ___No Seizures ____Yes ____No
Physical Limitation _____________________________________________________
Other Medical Information _______________________________________________

                                       Liability Release
The undersigned releases and agrees to hold harmless the General Board of Global Ministries of
the United Methodist Church, The UMVIM Board of the SOUTH CENTRAL Jurisdiction of the
United Methodist Church, the CENTRAL TEXAS Annual Conference, FIRST UNITED
METHODIST CHURCH MANSFIELD, and any related agency, conference, district, local church,
member, employee or agent, from any liability, injury, damages, loss, accidents, delay, or
irregularity related to the undersigned individual’s planned participation or involvement in the
above named UMVIM Project. The undersigned has been advised and understands that the
project may involve unusual risks to participants. Those risks may involve, among others, the
following: Dangers resulting from disease; from civil warfare or insurrection of the kind that we
have seen in recent years in Somalia, Bosnia, Liberia; from post-warfare hazards such as
landmines; from geographic features such as high altitude, which may have a deleterious effect
on persons with heart conditions or respiratory diseases; from extreme heat and humidity with no
air conditioning available, or from extreme cold with no central heating. The foregoing is not an
exhaustive list of dangers that may arise but is illustrative of some types of dangers that may be
faced. This release covers all rights and actions of every kind, nature and description, which the
undersigned ever had, now has or but for this release, may have. This release binds the
undersigned and his/her heirs, representatives and assignees.

Participant's Signature _____________________________________________________


Notarization of Liability, Medical, and Information Release Form

STATE OF __________________________ PARISH OR COUNTY OF ____________________
On this ________day of ______________, __________ (year), before me personally appeared
__________________ to me known to be the same person described in and who executed the
within instrument, and who acknowledged the same to be the free act and deed thereof.
Notary Public, _______________________________Parish or County_____________________
State of ____________________________My Commission Expires _______________________
                          RELEASE AND WAIVER OF LIABILITY

     Please Read Carefully. This Is A Legal Document That Affects Your Rights!

I, the undersigned, execute this Release and Waiver of Liability (the “Release”) on
______________, 20___, in favor of Juntos Servimos, a non-profit corporation, and its
directors, officers, employees, volunteers, representatives, contractors, and agents
(collectively, “Juntos Servimos”).

I wish to work as a volunteer for Juntos Servimos and engage in the activities related to
being a volunteer (the “Activities”). I understand that the Activities may include, among
others, construction and rehabilitating residential buildings and living in housing provided
for volunteers by Juntos Servimos.

I hereby freely, voluntarily, and without duress execute this Release under the following

Release and Waiver. I hereby release and forever discharge and hold harmless Juntos
Servimos and it successors and assigns from any and all liability, claims, and demands of
whatever kind or nature, either in law or in equity, which arise or may hereafter arise from
my Activities with Juntos Servimos.

I understand that this Release discharges Juntos Servimos from any liability or claim that the
I may have against Juntos Servimos with respect to any bodily injury, personal injury, illness,
death, or property damage that may result from my Activities with Juntos Servimos, whether
caused by the negligence of Juntos Servimos or otherwise. I also understand that Juntos
Servimos does not assume any responsibility for or obligation to provide financial assistance
or other assistance, including but not limited to medical, health, or disability insurance in the
event of injury or illness.

Medical Treatment. I hereby release and forever discharge Juntos Servimos from any claim
whatsoever which arises or may hereafter arise on account of any first aid, treatment, or
service rendered in connection with my Activities with Juntos Servimos.

                                . I understand that the Activities include work that may be hazardous to me,
including, but not limited to, construction, loading and unloading, and transportation to and from the work
sites. I hereby expressly and specifically assume the risk of injury or harm in the Activities.
Insurance. I understand that, except as otherwise agreed to by Juntos Servimos in writing,
Juntos Servimos does not carry or maintain health, medical, or disability insurance for any
volunteer. I am expected and encouraged to obtain my own medical or health insurance

Photographic Release. I hereby grant and convey to Juntos Servimos all rights, title, and
interest in any and all photographic images and video or audio recordings made by Juntos
Servimos during the course of my Activities with Juntos Servimos, including, but not limited
to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

Other. I expressly agree that this Release in intended to be as broad and inclusive as
permitted by the laws of the State of Texas and that this Release shall be governed by and
interpreted in accordance with the laws of the State of Texas. I agree that in the event that
any clause or provision of this Release shall be held to be invalid by any court of competent
jurisdiction, the invalidity of such clause or provision shall not otherwise affect the
remaining provisions of this Release which shall continue to be enforceable.
IN WITNESS WHEREOF, I have executed this Release as of the day and year written above.

Witness: ___________________________

Volunteer: _________________________ Volunteer: _________________________


City, ST, Zip ____________________________

Phone:                                        Email:

Minors (all Children Under Age 18)
I/we, the undersigned, have read and understood this release and all its terms. I/we warrant that
the above is true and correct in all respects and that no representations, statements, or
inducements apart from the foregoing have been made. I warrant that I am the parent or legal
guardian of the minor child whose name appears below and warrant and represent that I am
empowered to execute this release on his or her behalf. I consent to whatever emergency
medical care might be provided or available for injury occurring during the Activities.




___________________________________                    DATE ____________

Printed Name of Minor:


Signature of Minor:

_________________________________ Date _____________

Please Return Form to:             Tamara Wilkinson
                                   Juntos Servimos
                                   3911 Winter Park Lane
                                   Addison, TX 75001
                                  Notification of Death

 Name______________________________ Passport No._______________________
In the event of my death, should my death occur outside the United States, a family
member, or a bishop of The United Methodist Church, or a representative of the US
State Department/US Embassy is to be instructed by the following:

1. Immediately contact the following:
   A.    A consular duty officer at the US Embassy in the country where the death
        Phone__________________ Fax________________ E-Mail________________
   B.      United Methodist bishop’s office
        Phone__________________ Fax________________ E-Mail________________
   C.      My family or other ______________________________________________
        Phone__________________ Fax________________ E-Mail________________

2. My wishes are as follows:
       My body is to be cremated, if possible, prior to being shipped back to the United
    States. Where possible, arrangements for the cremation are to be made in
    consultation with the United States Embassy of the nation where the death occurred.
    My remains are then to be shipped to:
       If cremation is not possible, then my body is to be shipped home, in keeping with
    the requirements of the host nation, to (funeral home): ________________________
       I do not wish to have my body cremated. My body is to be shipped to the US, in
    keeping with the requirements of the nation where the death occurred, to (funeral
    home): _____________________________________________________________.
       All my valuables, money, and personal possessions are to be kept in the control of
    the representative of the United States Embassy and shipped to: _______________
In the event of death, all of the above instructions are to be followed in consultation with
the above-named family member if that family member’s physical condition and location
make such consultation possible. Further, all valuables, money, and personal
possessions are to be placed in the possession and control of the above-named family

Signature ____________________________________________ Date ____________
              (If under 18, must be signed by parent or guardian)


Notarization of Notification of Death Form

STATE OF ________________________ PARISH OR COUNTY OF_____________
On this ___day of _______, ____(year), before me personally appeared __________
to me known to be the same person described in and who executed the within
instrument, and who acknowledged the same to be the free act and deed thereof.

Notary Public _________________________ Parish or County _______________
State of _______________________My Commission Expires ________________

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