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Kids of Victory – Summer 2015
*Teen Ministry Team Sign-Up
Kids of Victory – Summer 2015
Teen Ministry Team
*To be a teen leader you must have completed the 7th grade or higher.
Grade Completed Spring 2015:
Male
Circle
First
Name:
Female
Age:
My teen
has
permission to participate in all Kids of Victory – 2015 events and field trips. I
give my consent for my teen to be photographed as a part of KOV programming
and non-profit promotions.
In the event that my teen needs medical attention during Kids of Victory – 2015,
I give permission for the Ministry Staff to administer medical treatment or admit
to a hospital for emergency treatment. I further agree to hold harmless and release from liability Southgate Church, its ministers, and anyone acting on behalf
of KOV for any and all injuries sustained while at KOV.
Last
Name:
Nick Name or name you want printed on t-shirt
Address:
Date:
City:
State:
The school I attend:
Home
Phone #:
Parent/Guardian’s Signature
Zip:
Mom’s
First & Last
Name:
Dad’s
First & Last
Name:
Teen’s
Cell Phone #:
Email:
Time: 8:45 a.m. – 4:00 p.m. Every Day
Which week are you available*?
Week 1: July 13-17
Week 2: July 20-24 Week 3: July 27-31
*Teens can only be a Teen Leader 2 of the 3 weeks.
If I choose to work 2 weeks I will work
Please circle one of the following: Week 1 & 2
Week 2 & 3
Cell #:
Cell #:
Emergency Contact Information:
Please Print Plainly
Name:
Relationship to Child:
I am interested in helping with special needs children: Yes No (Circle One)
Daytime Phone #:
T-Shirt Size: Adult S M L XL XXL (Circle One)
Cost: $10 per session to cover the cost of shirts and field trips.
(Working two sessions requires 2 shirts!) (1 session = $10, 2 sessions = $20)
Cell Phone #:
Allergies:
KOV Years of Experience:
Camper?
Years
Assistant Teen Leader?
years
Medications:
Return this completed form to:
Kids of Victory, 9820 East Watson Road, Crestwood, MO 63126
Include the cost for each shirt ordered
 Teens of Victory Camp
June 15-19 - Here at Southgate
 Breakfast of Champions:
Saturday, July 11, 8:30am-12:00pm - In the Southgate Cafeteria
Make checks payable to: Southgate Church
www.kidsofvictory.org and/or ‘Like’ us on facebook
Main Teen Leader?
Years