2025 9•12 Albuquerque Mission Trip

Participant Contact Information

Student Name

Student Phone Number

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Student E-Mail

Parent Name

Parent Phone Number

Parent E-Mail

Parent Address

Registration Information

Gender

Male
Female

Date of Birth

Grade You Will Be Entering Fall 2025

Terms & Agreement

Travel and Behavioral Terms and Agreements

TRAVEL TERMS:
As the parent or legal guardian of the above named minor, I give my permission for him or her to participate in the 9•12 Albuquerque Mission Trip from August 1-7, 2025. I give my permission for the above named minor to ride in the provided vehicles to and from the event and to multiple locations throughout the duration of the trip.

I understand, it is my responsibility to have my child at Christ's Church of Oronogo Student Ministry Center North by 6:00 AM on Friday, August 1, 2025. I further understand, that if the transportation leaves prior to my arrival, that there will be no refund of my registration fee.

The expectation is that each person attends the 9•12 ABQ Mission Trip with Christ's Church of Oronogo in its entirety and that they will travel to and from Albuquerque with the group.

I agree to be at Christ's Church of Oronogo, Student Ministry Center North on Thursday, August 7 at 8:00 PM to pick up my child at the completion of this trip.
**If circumstances change our arrival time, you will be notified by Christ's Church of Oronogo Student Ministry Staff.

I understand and grant permission for my child to participate in activities during the event including, but not limited to, cleaning , yard work, organizing, meal preparation, light construction work, painting, as well as participating in indoor and outdoor recreational games and activities.

I understand that there are inherent risks involved in these activities and the transportation between these activities. I hereby release Christ's Church of Oronogo, its staff, and volunteers from responsibility and liability for any injury or illness sustained during this event.

I authorize the minister, adult leader, or sponsor of this event, or any Christ's Church of Oronogo staff member, in the event I cannot be reached by phone, to give consent to a physician and or hospital for emergency medical or surgical treatment. It is understood that I will assume any financial responsibility for any expense that may be incurred for said emergency treatment.

BEHAVIORAL TERMS:
I understand that if attendee should exhibit behavior that is inappropriate, at the discretion of the Christ's Church of Oronogo staff, they will be sent home from the trip. Transportation will be the responsibility of the attendee's parent or guardian and the registration fee will not be refunded.

I have read and agree to the terms above.

I authorize Christ's Church of Oronogo to use photographs and/or video footage of my child for future promotional material.

Photography Release

By typing your full name, you are electronically signing this form and acknowledging that your online consent is equivalent to a binding legal signature.

Parent/Guardian E-Signature

Today's Date

Medical Information

Medical Insurance Company

Primary Name Insured on Policy

Policy Number

Physician's Name & Contact Number

Allergies

Special Considerations & Information

Medicines Currently Taking

Over-The-Counter Medication Approval

Over-the-counter medications will be available through the trip nurse. These include: ibuprofen, acetaminophen, naproxin, cold medicine, allergy medicine, Dramamine, Immodium, Pepto, Tums, antibiotic cream, hydrocortizone cream, sunscreen and aloe vera.

Please select one of the following options:

I agree to allow my child to receive the above listed over-the-counter medications if necessary.

Please do not administer the following medications to my child:

List any medication that you do NOT wish for your child to receive. State "ALL" if you do not wish for your child to be administered any of the above medications.

Parent/Guardian E-Signature

Date Field

Emergency Contact Information

Primary Emergency Contact

Phone Number

Secondary Emergency Contact

Phone Number

Payment Information

We require everyone to pay the deposit at the time of registration. If you only pay the deposit today, Regfox will deduct the remaining balance automatically on July 14.

Make Payment

See Payment Options ($475.00)

Coupon Code

Total

$0.00

Terms

I understand that as of July 14, 2025, my registration fee of $475 for the 9•12 Albuquerque Mission trip is due in full and non-refundable.

I have read and agree to the terms above.

By typing your full name, you are electronically signing this form and acknowledging that your online consent is equivalent to a binding legal signature.

Parent/Guardian E-Signature

Today's Date

Scholarship Fund

If you would like to increase opportunities for our students and leaders to attend trips and events through Christ's Church of Oronogo, please enter a donation amount below to contribute to our student ministry scholarship fund.

Your help is greatly appreciated! Thank you for partnering with us!

Donation Amount