Puente de Amistad Team Member Application: Minor

Puente de Amistad Team Member Application

Minor Application
Full Name of Minor*

Last NameFirst Name
Team or Group Information
Team Leaders Name

First NameLast Name
Team/Group Name (What do you call your team?)
Team Leaders E-mail
example@example.com
Team Member Information
Cellular Phone Number of Minor*

Area CodePhone Number
Full Name of Minor Guardian/Parent*

First NameLast Name
Cellular Phone Number of Guardian/Parent*

Area CodePhone Number
Minors Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Minor's Home Phone Number*

Area CodePhone Number
E-mail of Minor*
Birth Date of Minor:*

MonthDayYear
Date
Age of the Minor:*
Minor's Gender:*

MaleFemale
Please, upload a current photo of Minor. ( Current: within the last 5 days.)

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Church Information
Church Full Name
Church Phone Number

Area CodePhone Number
Church E-mail
example@example.com
Church Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information
Minor's Emergency Contact Name:*
Relationship with Emergency Contact:*
Emergency Contact Phone Number:*

Area CodePhone Number
Personal Identification Questions
Mother's Maiden Name:*
Favorite Sport:*
Favorite color:*
Do you have a passport"*

YESNO
Date of expiration on Passport:

MonthDayYear
Date
Do you have a Passport Card?*

YESNO
Date of expiration on Passport Card:

MonthDayYear
Date
Please Note:

A copy of your passport/passport card is a requirement of Puente de Amistad.

This is not a suggestion!!!
Upload a copy of your passport book or passport card: (Passport Book: Needs to be of your photo and all the personal information) (If you do not have a passport or passport card, upload a profile photo)*

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A good copy of your Passport is in your benefit! In the case of your passport or passport card being stolen or lost, you will need a copy to return to the United States of America. It is in your best interest to make the copy as professional as possible. Scanned copies are preferred by the Border Guards.
If you do not have a Passport Book or Passport Card you need to apply for one immediately.

You will not be allowed to stay at Puente de Amistad without one of these forms of identification.
Medical Information
*This information will not be used to determine eligibility. It is important for your safety while you are on the trip.
My overall physical condition is:*

ExcellentGoodFairPoor
If your answer was anything other than "Excellent" please explain why:
Please list all food allergies:
List all medications that you are taking and their purpose:
Doctor's Name
Doctor's Phone Number

Area CodePhone Number
Date of last Tetanus Inoculation:*

MonthDayYear
Date
Health Insurance Carrier:*
Health Insurance ID Number:*
Group Number:
Is your medical insurance valid outside of the United States?*

YESNO
Puente de Amistad Waiver of Liability, Code of Conduct, and Team Member Covenant
Waiver of Liability

The undersigned participant and parent/guardian do hereby consent to participate in or have our son, daughter, or ward participate in the noted activity organized by Puente de Amistad, a ministry of Open Bible Standard Churches, a religious, non-profit corporation. We have been informed that a foreign country is very different from the United States. We have been apprised that there are risks politically, militarily, culturally, safety-wise, and health-wise and that problems in any or all of these areas may arise during this mission trip. We have been apprised that, in Tijuana, Mexico, there is currently an added risk of rapid kidnappings and other violent crimes, which are mainly related to criminal activity with drug cartels. In addition, we have been apprised that the threat of terrorism against Americans increases on foreign soil. We are also aware of the threat of terrorism in air travel both from American and foreign airports. We also understand that this trip will involve mission activities, sporting activities and interacting directly with the people while on this trip. Having been so informed we give our permission for our son/daughter or ward to participate in the above named mission trip and we agree to assume all expenses occasioned by any injury or loss.

The undersigned participant agrees to abide by and the undersigned parent or guardian agrees that the participant is bound by the rules and regulations, supervision, and discipline set and applied by Open Bible Standard Churches and Puente de Amistad and its agents and the undersigned parent/guardian does hereby authorize Puente de Amistad or its staff members or other agents to arrange for and consent to X-ray examinations, anesthetic, dental, medical, or surgical diagnosis, and treatment for his or her son, daughter, or ward.

The undersigned parent/guardian will furnish payment or insurance for any such treatments, at his/her own expense.
We have read the above and completed the medical information; we understand its content and import and agree to its provisions. We hereby declare this permission form is executed without reliance upon any statement or representation of Open Bible Standard Churches or Puente de Amistad or any agent, employee or volunteer thereof and the execution is made voluntarily and knowingly.

Important Advisory: Individuals traveling to a foreign country and reentering the U.S. are advised that having illegal substances (drugs) or illegal merchandise in their possession will subject them to severe penalties including fines and imprisonment as prescribed by each country. Violation of such laws overseas often results in automatic and lengthy prison terms.
Code of Conduct

As a Christ-centered ministry base under the auspices of Open Bible Churches, Puente de Amistad bases its values and code of conduct concerning human sexuality and gender upon its understanding of biblical standards.

 Accordingly, all staff, volunteers, and guests are not permitted to publicly identify or present as a gender that differs from their biological sex or sex assigned at birth or to request pronouns of their preference.

 All staff, volunteer and guest correspondence, documents, and records will reflect their biological sex.

 All staff, volunteers, and guests will use bathrooms that correspond with their biological sex while at the base of Puente de Amistad or while participating in programed activities outside the base.

 Puente de Amistad believes in the sanctity of sex as reserved for marriage between a biological man and a biological woman and prohibits both heterosexual sexual intimacies outside of marriage and same-sex displays of
affection by staff, volunteer or guests.

 Failure to comply with this code of conduct or speaking out against it as a staff member, volunteer or a guest at Puente de Amistad will be cause for loss of staff position, volunteer’s position or guest privileges and dismissal from the premises.
Team Covenant

I having been told and fully understand what will be expected of me while in Tijuana, and do hereby give my word to adhere to the following:

1. Respect the people and culture of Mexico, and abide by Mexican laws, both legal and social;

2. Obey our authorities and respect each member of the team as well as others we may work with on the trip;

3. Abide by the rules of Puente de Amistad and do nothing that could damage the reputation of Open Bible in Tijuana;

4. Maintain a positive attitude despite hardships and inconveniences;

5. Set aside romantic interests in other team members or people we may meet on the trip until after the trip is over;

6. Pray for team members on a daily basis; and

7. Attempt with all of our being to follow the example of Jesus Christ in all things.
Print Name of Minor*

First NameLast Name
*By signing in this box, you are stating that you have read the "Team Member Guide" and agree to follow all the rules, terms, policies, and pay agreements set forth by Puente de Amistad, either in the "Team Leader Manual", "Team Member Guide", or Puente de Amistad's (websitepdeamistad.org).
Minor's Signature: Waiver of Liability*
Print Guardian/Parent Name*

First NameLast Name
*By signing in this box, you are stating that you have read the "Team Member Guide" and agree to follow all the rules, terms, policies, and pay agreements set forth by Puente de Amistad, either in the "Team Leader Manual", "Team Member Guide", or Puente de Amistad's (websitepdeamistad.org).
Date/Time
Signature of Guardian/Parent Name*
Should be Empty:

Puente de Amistad Team Member Application

Team or Group Information

Team Member Information

Church Information

Emergency Contact Information

Personal Identification Questions

Medical Information

Puente de Amistad Waiver of Liability, Code of Conduct, and Team Member Covenant