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BOUNDARY WATERS ADVENTURE — Application Process

July, 2019—Sponsored by United Church of God, an International Association

Dear Applicant—thanks for your interest in BWA! This page is an overview of application process, pages 2-3 actual application.

Application Phase 1: Items due by April 15, 2019

➢ The four pages below constitute your official application. Everything must be filled-out and included.

➢ A check for $175, made out to “United Church of God, IA” with a note that it is for “Boundary Waters Adventure”.

➢ The completed Health Form (below as well), including physical exam.

➢ All documents and photo need to be sent in hard copy to the address listed below.

Application Phase 2: April 15 – May 1, 2019

➢ If I do not know you well, or if I have questions about your application, I may want to conduct a face-to-face or Skype interview. This will not apply to everyone.

➢ Acceptances sent via e-mail by May 1, 2019 (sooner if possible) & contingent upon fulfilling the requirements below.

Application Phase 3: Items due by June 1, 2018

➢ 12-minute run test – “how far can you run in 12 minutes, without stopping?” (Please e-mail the distance to me.)

o Example: 1.5 miles

➢ Affirmation that you have completed the required reading. (Book will be sent to you upon provisional acceptance).

All communications from me will be conducted by e-mail or phone calls—please contact me with any questions. I look forward to receiving your application and hope you can join us at Boundary Waters Adventure!

Frank Dunkle, Director of BWA, Cell: 740-648-0041 /ABC Office: 513-843-4006 ; E-mail: frank_dunkle@

|PERSONAL STATEMENT | | |

After reading the online Program Description, please answer the questions below. Answers need to be specific and they need to demonstrate personal reflection on what you want to accomplish at BWA and what you can contribute to it.

1. What aspects of Boundary Waters Adventure excite you about participating?

2. BWA is a great opportunity to learn more about yourself, who you want to become, and how to make changes. This is important knowledge for individual and group leadership. Briefly discuss two characteristics about yourself that you would like to explore & grow in at BWA (spiritual in nature or other areas). (Only need 1-3 sentences per area.)

1)

2)

3. Boundary Waters Adventure is not simply a “guided tour” of great scenery. It is an immersion program that is designed to make a difference in all participants. Briefly discuss two strengths that you will bring to this program that will help the group achieve results from this adventure. These can be spiritual in nature or address other areas as well. (Only need 1-3 sentences per strength.) 1)

2)

5. Briefly describe your current work, career or student status and your plans for the next 3-5 years.

BOUNDARY WATERS ADVENTURE — Participant Application

July 2019

Sponsored by: United Church of God, an International Association

Please read the online Program Description before completing this application. (This application can be filled in & saved.)

List any training or current certifications you have that are related to the outdoors, backpacking, canoeing, orienteering, etc.

Swimming Proficiency: Can’t swim Beginner Intermediate Skilled Lifeguard

REFERENCES—Please list three non-family references who know you well.

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|1. |Relationship: |Phone: |

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|2. |Relationship: |Phone: |

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|3. |Relationship: |Phone: |

BOUNDARY WATERS ADVENTURE 2019 —AGREEMENT, RELEASE & SIGNATURE REQUIRED

Boundary Waters Adventure will maintain a high standard of conduct and dress, based on God's laws. These standards and rules include, but are not limited to: No possession or use of alcohol, tobacco or illegal drugs; no sexual misconduct, theft, smoking, disorderly conduct, profanity, destruction of property or refusal to cooperate fully with the program staff. Jewelry for body piercings (other than earrings for girls), short shorts, midriffs, halter-tops or wearing revealing or other inappropriate apparel (or the lack thereof) will not be allowed. Pets and personal sports equipment are not allowed, except as noted in the acceptance package. Firearms or other weapons (except pocketknives) may not be brought without the written permission of the director. Under certain circumstances I am aware that a search of my belongings or living quarters may be made in my presence by program staff. Participants who do not comply with the program's rules and standards, or whose conduct or attitude undermines the positive environment and objectives of the program, or who have made any false, misleading or incomplete statement in this application are subject to being dismissed. If the participant is dismissed, he or she will be sent home at his or her own expense.

By my signature below, I also hereby give consent and permission to the non-exclusive, non-commercial reproduction, publication or use by United Church of God, an International Association ("Church") or anyone authorized by them, of any pictures or photographs (still, video or motion, individual or group), taken of me at Boundary Waters Adventure or its related activities (including travel) or, if taken during any other Church-related activities, together with any caption or descriptive material, including the individual/participant’s name, without compensation to the undersigned. Said picture(s) may be used without limitation, on Church Web site(s), in Church publications, in "Festival" or other videos or promotions created by the Church, in Church-sponsored advertising or in any television program or broadcast approved by the Church.

I am aware of the activities of Boundary Waters Adventure and I believe I am in good health and can participate in strenuous activities and the usual routine associated with Boundary Waters Adventure. I am aware that there are inherent risks associated with this activity, including but not limited to injury or death due to falling rock or falls from rock, failure of equipment, exposure to severe weather, and other risks associated with adventure activities in the outdoors/wilderness. In consideration of being allowed to participate in Boundary Water Adventure, I hereby release, indemnify, save and hold harmless and covenant not to sue the United Church of God, an International Association, their officers, Council of Elders, agents, employees, volunteers and helpers and any other related entity (hereinafter collectively called the "Church") from all actions, claims, demands or suits which are based upon, or result from injuries sustained by the applicant arising out of, or in the course of, said applicant’s participation or attendance at Boundary Water Adventure, even if caused by the Church’s negligence. This release, however, shall not be applicable to claims covered by the Church’s liability insurance, but is applicable to claims not covered by that insurance. It is highly recommended that you have your own insurance protection since you are participating at your own risk.

Applicant: I have read, fully understand, and agree to the foregoing and will comply with all the rules and standards of the program and its staff. I understand and agree with its implications and the stated consequences.

Applicant Signature

Date

Mail this application & with “Health & Insurance Form” below by April 15, 2019 to:

Frank Dunkle, Phone: 513-843-4006

555 Technecenter Dr. E-mail: Frank_Dunkle@

Milford, OH 45150

Those accepted will need to send physical exam, 12-minute test and travel plans upon acceptance.

Tuition is $175 (Check made out to United Church of God) and participants must purchase a 2019 Minnesota fishing license (a week license for non-residents). Participants are expected to provide their own sleeping bag, pup tent and personal gear (including rain gear, bug spray, etc.). Canoes, food and all equipment for cooking are provided by the Boundary Waters Adventure program.

BOUNDARY WATERS ADVENTURE “Health and Insurance Form”

Sponsored by:

United Church of God, an International Association

PERSONAL INFORMATION (Please type or print clearly in all sections)

Applicant's Name: Sex: Male Female Birth Date: / / .

First M.I. Last

Address: Phone: ( )

Street Address City State Zip

Social Security Number of Participant: - -

Parent/Guardian or Emergency Contact: Relationship:

Telephone: ( ) ( ) ( )

Home Work Other

Second Parent/Guardian/Emergency Contact: Relationship:

Telephone: ( ) ( ) ( )

Home Work Other

MEDICAL / HEALTH HISTORY

Health History – Explain any “yes” answers below

Does/did the participant have: YES NO YES NO

1. Recent injury, illness or infectious disease?..........

2. Mononucleosis in the past 12 months? .................

3. Chronic or recurring illness/condition? ..................

4. Diabetes? ..............................................................

5. Food allergies? ......................................................

6. Allergic to any medications (list below) .................

7. Respiratory problems or asthma? .........................

8. Frequent headaches, or migraines?......................

9. Ever passed out during or after exercise?.............

10. Ever been dizzy or faint during or after exercise? .

11. Ever experienced altitude symptoms? ..................

12. Ever had seizures?................................................

13. Ever had chest pain during or after exercise? .......

14. Heart murmur? ......................................................

15. High blood pressure? ............................................

16. Deep vein thrombosis? .........................................

17. Blood disorder? .....................................................

18. Back injuries or problems?....................................

19. Joint injuries? ........................................................

20. Sleepwalking? .......................................................

21. Eating disorder? ....................................................

22. Overweight or underweight? .................................

23. Emotional or mental difficulties for which

professional help was sought? ............................

24. (Females): Treatment for menstrual cramps?.......

25. (Females): Pregnant? ...........................................

If you checked “yes” to any of the above, please note the question # and explain, including any continuing medications needed.

Please list all medications (including over-the-counter or other nonprescription drugs) taken routinely. Be sure to bring your medication with you in the original packaging that will identify the doctor, the dosage and the frequency of administration:

|Medication |Dosage |Frequency |Reason for Taking |

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Do you have any health issues that might hinder you from participating fully in the program as described? Yes No

If yes, please describe in detail (attach note if necessary):

Which of the following has the applicant had? (Check each one that applies)

Measles Chicken Pox German Measles Mumps Rheumatic Fever

Hepatitis A Hepatitis B Hepatitis C TB Test (Date: , Pos or Neg? )

Immunizations – Fill in the dates for any of the following immunizations applicant has had.

|Immunization |Date Last Received |Immunization |Date Last Received |

|DPT | |Mumps | |

|TD (tetanus/diphtheria) | |Rubella | |

|Tetanus | |Gamma Globulin (Hepatitis) | |

|Polio | |Chicken Pox | |

|German Measles | |Smallpox | |

NOTE: A record of immunizations is for informational purposes. Immunizations are not a required prerequisite for acceptance or attendance. If a participant has not been immunized, however, and one of the above-named communicable or contagious diseases is found in the group, he or she will be subject to the regular quarantine or isolation procedures of the program and of the community for persons who are not immune.

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| |Who should be contacted in case of emergency? |

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| |Relationship Home phone Cell phone Work phone |

|Name | |

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ADULT APPLICANT: I certify that to the best of my knowledge that this health history is accurate and complete, that I am in good health and able to participate in this program.

Adult applicant signature: Date

INSURANCE COVERAGE AND RELEASE

Insurance Company: Policy or Group # Social Security Number of Policyholder or Insurance ID Number: Policyholder Date of Birth: Insurance Phone # ( ) Address: Family Physician: Phone: ( ) Address: Family Dentist/Orthodontist: Phone: ( )

Address:

Personal Medical Insurance

While we place a significant emphasis on safety in the Boundary Waters Adventure program, accidents may happen and people may get injured. For this reason, we strongly recommend that you carry adequate personal medical insurance. We realize that it is not always affordable. However, paying actual hospital and doctor expenses can easily cost far more. As we review your application, this is an important factor in determining those most suited to participate in the program.

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Supplemental Accident Insurance

We realize that your personal insurance may require you to pay a deductible and co-payments, and possibly other costs. In an effort to help reduce the cost to you personally, the Church has been able to acquire supplemental accident medical coverage for a nominal cost. Though the Church is unable to provide financial assistance beyond what is offered through this insurance, we are happy to include all program participants in this coverage. The extent (amount and period) of accident coverage may vary from year to year. If you are accepted to this program, a copy of the coverage will be supplied upon request.

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Release and Waiver

I have read, fully understand, and agree to comply with all the rules and standards of the project and its staff. I understand and agree with its implications and the stated consequences. I also affirm that the information given in this application is true and complete and that I am in good health and able to participate in the expected activities and routine for the project(s) marked on the front. In consideration of being allowed to participate, I hereby release, indemnify, save and hold harmless and covenant not to sue the United Church of God, an International Association, its officers, Council of Elders, agents, employees, volunteers and helpers and any other related entity (hereinafter collectively called the “Church”) from all actions, claims, demands or suits which are based upon, or result from injuries sustained, arising out of, or in the course of, participation or attendance at camp. This release, however, shall not apply to claims covered by the Church’s liability insurance (e.g. for its negligence) , but is applicable to claims not covered by that insurance. It is strongly recommended that you have your own medical insurance protection since participants are involved in activities at their own risk.

Signature

Date Signed

Print Name_ __

MEDICAL EXAM / RECOMMENDATION AND RESTRICTIONS

Send these pages along with your application. Upon acceptance, a medical exam will also need to be submitted.

An exam by a medical practitioner is to be done within 12 months of participation in the program. Use the form below or attach a similar practitioner’s exam form. Submit your most current exam form for each program session.

Applicant’s Name: Birth Date: / /

I have examined the above named participant on / / (date). BP Weight Height In my opinion, the above applicant: is is not able to participate in an active outdoor wilderness/adventure program.

The applicant is under the care of a physician for the following conditions

Current treatment at the time of this report includes

Recommendations and Restrictions for the “Boundary Waters Adventure”

Treatment to be continued at camp

Medications to be administered at the program (name, dosage, frequency)

Any medically-prescribed meal plan or dietary restrictions

Known allergies

Description of any limitation or restriction on program activities

Additional information for health care staff at the program

Signature of Licensed Medical Personnel Printed name Title Address

Phone Date

BOUNDARY WATERS ADVENTURE

July, 2019

Sponsored by: United Church of God, an International Association

CONDITIONING GUIDE

Disclaimer: This document is intended to provide overall guidelines and ideas for physical conditioning in preparation for the Boundary Waters Adventure program. It is not intended to be a specific training regimen or requirement for any given participant. It is recommended that each participant consult with his/her licensed medical physician before deciding upon a workout program.

A. Overall Training Principles (adapt accordingly)

1. Frequency. Best results are obtained if a person maintains a regular schedule of exercise. Most trainers recommend 4 – 5 days a week. It is just as important to rest 2 days throughout the week from rigorous exercise. Intense workouts actually break-down muscle tissue – which is rebuilt during rest.

A 45-minute workout per day is optimal and with good planning, should be able to fit into most schedules. This would include 25-minutes of cardiovascular/aerobic exercise and 20 minutes of muscle workout.

2. Cardiovascular & Aerobic. To improve aerobic and cardiovascular conditioning, it is best to maintain an elevated heart rate – 1.5 to 2 times your resting heart rate – for at least 25 minutes continuously.

3. Muscle Training: Upper Body vs. Lower Body. Most people involved in muscle training (weight-lifting and muscle building exercises) usually alternate days between upper-body and lower-body workouts – in order to allow the other set of muscles a day to rest and rebuild. For example: on Monday, a person may do his aerobic workout + all upper body strength training; on Tuesday, a person would then do his aerobic workout + lower body strength training (and then continue to alternate throughout the week).

In weight training, you have the option of using heavier weights with fewer repetitions (reps), or somewhat lower weights with higher number of reps. While you need a sufficient level of weight to challenge and build muscle, generally it is recommended to have somewhat lower weights and a higher number of reps. This will serve you better for this program, where we will be hiking or rock-climbing over an extended period of time.

A final note with regards to weight training: whenever possible, do each arm (and each leg) separately. If done together, your stronger arm or leg will always compensate for the weaker one. For example: if you are doing arm curls, use a separate dumbbell for each hand/arm, rather than one bar for both arms at the same time.

4. Form. Very important in any exercise – especially weight lifting – is using the correct form / technique. This can greatly increase the effectiveness of the exercise and reduce the risk of injury. Consulting a coach or personal trainer (if you are unfamiliar with an exercise) may be a good idea.

5. Diet. It does little good to give your body a good workout – but then not the nutrients to build itself back up. The best nutrition consists of a healthy balance of fresh foods that include protein (meat, nuts, milk), vegetables, fruits and complex carbohydrates (whole grain breads & rice). Foods to minimize would be almost all processed foods (especially processed carbohydrates and sugars), sweets, “junk food”, snack-foods and soft-drinks.

6. Stretching. Do not underestimate the value of careful stretching before and after working out. This can greatly reduce the risk of stress injuries and help you to feel “less sore” after a workout.

7. Start Slow – and then Increase. If you are not used to regular exercise, you won’t become a “fitness machine” overnight. For aerobic and cardiovascular, do what you reasonably can – that is still somewhat of a challenge – for 30 minutes and then increase speed or resistance on a progressive basis. In weight training, start with a lower weight, and increase every couple of weeks.

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| |PLEASE ATTACH A |

| |RECENT PHOTO |

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| |(A current photo is required for insurance & |

| |emergency management purposes). |

|PERSONAL INFORMATION — Please print clearly or type. | |

|Last Name (print): |First |Middle | |

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|Address: | |

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|City: |State: |Zip: | |

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|Telephone: ( ) |Email: | |

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|Birth date: / / |Are you a baptized member? Yes No | |

| | |Date of Photo? |

| | |Office Use Only | |

|Age by July 1: |Do you attend services regularly? Yes No | | |

| | |Date Recd. Tuition Paid Health | |

| | |History Physical Exam | |

| | |12-min. run test Travel/Info. form | |

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|Congregation: |Pastor: | | |

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|Male Female Single Married Have children | | |

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|T-shirt Size: : __ S M L XL XXL | | |

|EXPERIENCE | | |

|If you served on United Youth Camps staff, a Youth Corps project or attended a Challenger | | |

|Program list below from earliest to most recent. | | |

|Year Camp/Program Director Staff Job/ Experience | | |

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