Foothills Congregational Church

United Church of Christ 461 Orange Ave., Los Altos, Ca 94022 650-948-8430

Thank you for considering chaperoning the 2013 Youth Mission Trip to build a home through Amor Ministries on the Apache reservation in Arizona from June 22nd to June 29th. Chaperoning the youth mission trip is an opportunity to both contribute to the development of the youth of our community and make a positive impact in the world by putting our faith to work. Your participation is appreciated.

This packet should contain all of the information you need about what it means to chaperone a youth mission trip. If you have questions that are not answered here, please contact me so that I can answer them for you. In the packet you will find: Chaperone Expectations, Chaperone Registration Form, Chaperone Release Slip, General Information about Leaders/Chaperones, and a copy of the Faith Development Board’s Children and Youth Policies.

In order to officially sign-up as a chaperone on the trip, please return a completed Chaperone Registration Form, Chaperone Release Slip, and a $100 non-refundable deposit to the Faith Development Board Mission Trip Lead, Cindy Anderson, by November 25th, either by handing them to her on a Sunday morning, or by putting them in the “Mission Trip” box in the work room behind the adult library. After November 25th all of the adult leaders and chaperones will get together to talk about who will perform what role on the trip.

Blessings,

Rev. Michelle Webber Associate Minister Foothills Congregational Church, United Church of Christ [email protected]

2 Foothills Congregational Church Mission Trip: Chaperone Expectations

All Chaperones are to fill out and return the Chaperone Slip and Registration Form, as well as any paperwork required by our partner agency. Chaperones that are not church staff will need to complete a background check authorization form and turn in a deposit check. All chaperones are expected to participate fully in the planning and fundraising before the trip in order to develop relationships with all youth going on the trip. On the trip, chaperones are expected to model appropriate behavior and to refrain from using alcohol, tobacco, and illegal drugs. Any behavior or information witnessed or received from a youth that leads you to believe the youth or someone else is in danger of being harmed or harming others must be, at least, reported to the Chaplain and the Director. You are encouraged to use your best judgment about reporting such behavior to outside authorities.

Chaperones are to abide by the Faith Development Board’s Children and Youth Policies at all times.

Any chaperone who is driving their personal vehicle must carry car insurance in compliance with state law and travel with a jack, a spare tire, and a set of jumper cables. They must have a copy of their valid driver’s license on file in the church office.

Chaperones are to turn in any receipts for items purchased on the trip, such as gas, to the FDB Camps and Classes Ministry Team Lead assigned to the Mission Trip in a timely manner after the completion of the trip.

After the trip, chaperones are expected to help clean camping equipment for storage and to participate in a thank you event for the whole congregation, as a way of both connecting the congregation to what we did and to thank them for their financial support. The event will be scheduled at a time convenient in the church calendar and for the most trip participants.

3 General Information about Leaders/Chaperones

To be in compliance with FCC’s Safe Church Policy, we will need at least 3 chaperones. It is a best practice to have at least one male and one female chaperone. We have found that the trip works best with 5 adults, filling the following roles.

Director- This person is responsible for planning all of the logistics of the trip from where we will work to how we will get there, leading the leadership team, and participating with youth in fundraisers. Chaplain- This person is responsible for providing meaning making and faith development opportunities before and during the trip that relate to the work we are doing. Some of the activities have included, secret buddies, The Book, morning devotions, and evening programs. Nurse- This person is responsible for any first-aid needs that come up during the trip. Work Coordinator- This person will be the on-site coordinator for our work during the trip and will be the primary person responsible for communicating with the work- site coordinator for the organization with whom we are working. Food & Water/“Mama Bird”- This person is responsible for everything we eat and drink during the week, coordinating meals at camp as well as keeping people hydrated during work hours.

In addition, Faith Development Board procedures require a dedicated board member work with the Mission Trip Team. FDB Camps & Classes Ministry Team Lead- This person is a member of the Faith Development Board and works with the adult leaders to plan the trip. This person is responsible for registration and budget. This person may or may not actually go on the trip.

Parents of youth who are participating on the trip are always welcome to attend the trip. It is best if they take on one of the defined roles as well. If there is a year with more than 5 adult chaperones, one of the above roles can be split as it is useful for all adult participants to have defined roles.

4 Foothills Congregational Church United Church of Christ 461 Orange Ave., Los Altos, Ca. 94022

Chaperone Registration Form FCC 2013 Youth Mission & Justice Trip

Name:______Birthdate: ______

Phone #: ______email: ______

Address: ______

In case of emergency:

Name of Doctor: ______Phone #: ______

Location: ______

Health Insurance Provider: ______Name of Primary Insured: ______

Medical Record # ______

Please list allergies, medical conditions, and medications: ______

Name of Dentist: ______Phone #: ______

Location: ______

Health Insurance Provider: ______Name of Primary Insured: ______

In case of emergency, please call: ______

Phone #: ______Relationship: ______

During the trip copies of this form will be kept in the church office, with the trip director, and in the car in which you travel. The trip director, Camp Nurse, Chaplain, and Church Administrator will have access to this form. After the trip this form will be shredded.

5 Foothills Congregational Church United Church of Christ 461 Orange Ave., Los Altos, CA 94022

Chaperone Release Slip FCC 2013 Youth Mission Trip

I, ______, agree to participate in the Foothills Congregational Church mission trip to Amor Ministries: Apache Reservation, Arizona to the fullest of my abilities. Such participation might include car travel, physical construction work, camping, supervision of minors, and participation in other reasonable activities. I understand that pictures taken of me while on the trip might be used for future FCC publicity, including on Facebook, unless I request otherwise.

In case of emergency due to injury or illness, I give my permission for staff and volunteers of Foothills Congregational Church to authorize any necessary emergency medical or dental treatment. I have listed all pertinent medical conditions on the opposite side of this form in the section titled, “allergies, medical conditions and medications.” If new medical conditions arise that may affect emergency medical treatment, I agree to inform Foothills Congregational Church by filling out an updated registration Form.

I agree to help plan and lead a fundraiser prior to the trip and to make myself available to report back to the church about my experience on the trip. I agree to fill out and return all necessary forms by their due dates and to be responsive to the leaders of the trip whenever they need to contact me.

Please check all boxes below that are true  I agree to drive my personal car on the trip, carrying youth and gear. I am a licensed driver.  I agree to allow other licensed adult drivers on the trip to drive my car, if needed  I authorize Amor Ministry to use my image on their website or Facebook page.  I have read and agree to follow the Mission Trip Procedures section titled “Chaperone Expectations”

Print name Signature Date

During the trip copies of this form will be kept in the church office, with the trip director, and in the car in which you travel. The trip director, Camp Nurse, Chaplain, and Church Administrator will have access to this form. After the trip this form will be shredded.

6 Foothills Congregational Church Faith Development Board Children and Youth Policies

I. Always comply with the Safe Church Policy. See attached Faith Development Board Safe Church procedures.

II. Programs shall adhere to the FDB Mission Statement The Foothills Congregational Church Faith Development Board's mission is to develop opportunities, rooted in Christian spirituality, to learn about and practice our faith and nourish a respectful and welcoming community.

III. Programs shall adhere to the FCC Vision Statement OUR VISION: We are an Open and Affirming Congregation, which means we provide a spiritual home that welcomes each individual as a beloved child of God. We affirm the humanity of all people, welcoming into the full life and ministry of the church, people of every ability, age, ethnicity, culture, economic status, gender, sexual orientation and religious belief.

IV. Adhere to the motto that “No matter who you are or where you are on life’s journey, you are welcome here,” being flexible to meet the needs of individuals when doing so does not violate our safe church procedures or inhibit the participation of others.

V. Minor participants shall have a signed registration form on file.

7 Faith Development Board Safe Church Procedures (Excerpted from FCC Safe Church Policy & Procedures)

D. PROTECTION OF CHILDREN AND YOUTH

D.1 Children and Youth Protection Policy

Foothills Congregational Church is committed to creating a safe and healthy environment in which young people can learn about and experience God’s love. In order to ensure this, we will provide supervision for all activities and programs involving children and youth, and employ practices that provide for the safety of children, youth, and those who care for them.

D.2 Definitions

Child: a person under the age of 11 not yet in grade 6

Youth: a person age 11 to 18 and in grade 6 through high school

Supervisor: a paid or volunteer worker who has direct responsibility for the care of youth, such as a teacher, youth group leader, or choir director. A supervisor who works with children or youth must have completed an application which authorizes FCC to conduct a background check.

Chaperone: a volunteer who helps supervise youth for a special activity, such as a party or field trip. A chaperone who works with youth must have completed an application which authorizes FCC to conduct a background check.

Helper, assistant: a volunteer for regular children or youth activities, such as Sunday programs and related activities or youth groups, who functions in a non-supervisory role.

Field Trip: a youth event that is scheduled off FCC property, whether for in-town or out-of-town, one hour, one day, or overnight.

Age Rules: a. classroom supervisors and chaperones must be five years older than the oldest participant in the class, group, or activity. b. the minimum age to supervise in the nursery or help in Sunday programs is thirteen.

D.3 Protection Procedures

D.3.1 Supervision

8 1. We expect that adults who volunteer to work with children and youth will have been members of FCC for at least six months or, if not members, will have been regularly and frequently associated with FCC for at least a year, or be known by FCC clergy for at least six months. 2. All volunteers and employees who regularly work with children and youth will receive orientation regarding these Safe Church Policies and Procedures. 3. It is the policy of the church to provide adequate supervision and safeguards for all activities. a. Two or more adults will be present during all children’s and youth’s programs and activities wherever possible. b. Two adults or one adult and a helper will be present when more than four children are in the nursery or when more than eight children are in a Sunday program c. In the event that two adults are not present, a second adult will check in periodically. d. If there is no window in the door, the door must remain open whenever children or youth are present. 4. All children participating in a class or program will remain with the group throughout the program. Children will not be permitted to separate from the group activity or from supervision until being turned over to a parent or guardian or to an older youth who has been given permission. 5. A parent or guardian will provide contact information and instructions for the care of infants and toddlers left in the nursery during worship or other church events.

D.3.2 Interacting with Children 1. Supervisors are encouraged to listen to the youth and clearly communicate expectation of appropriate behavior. 2. If a child’s behavior is disruptive, one of the adults in the classroom may leave to seek the Sunday supervisor, the Associate Minister, or the child’s parent or guardian to come to the classroom. 3. No child or youth will be disciplined by the use of any form of physical punishment. 4. Adults will touch children only in appropriate ways and places such as on the hand, shoulder or back, avoiding discomfort or over-stimulation of the child. 5. Adults will not touch children against their will except to protect the child or other people.

D.3.3 Field Trips/Youth Event Guidelines 1. The Faith Development Board should be aware one month in advance of all field trips and all evening or overnight functions at the church except regular youth meetings. 2. All field trips or events should receive the approval of the Faith Development Board before the activity can take place and before

9 fundraising for the activity begins. 3. All chaperones for youth activities must be approved by the AMCE. 4. If the chaperones for a trip or event are married, a third chaperone is required. 5. Parents or guardians should be fully informed about programs, activities, leaders, chaperones, dates and times, cost, method of transportation, and purpose of a scheduled trip or activity. The appropriate Consent and Medical Release Form should be completed and returned before any child or youth can participate in the trip or event. 6. Vehicle Rules: a. Drivers for field trips must be 25 years or older and have a copy of their driver’s license and registration on file in the church office. b. All occupants of a vehicle will use a seat belt. c. Supervisors or chaperones may drive a participant home following an event with prior permission from a parent. d. Licensed drivers may drive themselves home at the end of an event.

D.3.4 Medical Release Forms 1. All children and youth participating in a group event or going on a field trip must have a Consent and Medical Release Form on file before their participation. 2. The completed form will be kept on file in the AMCE office until the end of the event or term after which it will be shredded. 3. Each time a field trip or overnight event occurs, the original of the form must be taken with an adult leader while a copy remains in the AMCE office.