2012 Center for Courageous Kids Application DUE: Monday, October 1, 2012 by 4pm to the Student Center Ticket Office (Rm 253) CONTACT: Drew Ritzel Director of Alternative Breaks Center for Community Outreach University of Kentucky 106 Student Center Lexington, KY 40506-0030 PHONE: 859-257-9385 EMAIL: alternativebreaks@ukcco.org WEBSITE: www.ukasb.org Puja Singh Director of Project Health Center for Community Outreach University of Kentucky 106 Student Center Lexington, KY 40506-0030 PHONE: 859-257-9385 EMAIL: projecthealth@ukcco.org Page 1 of 5 Date: Location: Theme: October 12-14, 2012 Center for Courageous Kids, Scottsville, KY Children with Dravet Syndrome and their Families Dear Applicant, We are so excited that you are interested in our Fall 2012 weekend service trip! As a part of Alternative Service Breaks program, the Center for Courageous Kids (CCK) weekend service trip provides a unique volunteer opportunity, and an alternative way to get involved, for students, faculty, and staff at UK. For our weekend service trip, we will be volunteering at the CCK in Scottsville, KY, working with children affected by Dravet Syndrome. CCK provides a camp-like experience for children with extraordinary medical challenges and their families. At the camp, we will serve as den counselors to children and families participating in Dravet Family Weekend, which will allow volunteers to be matched with a family and to be a liaison with the camp. By volunteering at the Dravet Family Weekend, you will serve children affected by Dravet Syndrome and their families, learn more about Dravet Syndrome and related medical issues, and of course connect with other students, faculty, and staff at UK. The CCK weekend service trip will take place from 11am on Friday, October 12, 2012 to approximately 6pm on Sunday, October 14, 2012. All participants must actively engage in all aspects of the service trip, and may not come late or leave early from the service trip. Along with your application to participate in the service trip, a $25.00 non-refundable program fee is due to the Student Center Ticket Office (2nd Floor of the Student Center). This will cover the cost of lunch on Friday and your program tshirt; the Center for Community Outreach will cover all other trip costs. Applications will be accepted on a first come first served basis due to the limited number of volunteer spaces, up until Monday, October 1st, 2012 at 4pm. Submit your application early to ensure your place on this weekend service trip! In addition to participating in all aspects of the service trip, CCK participants will be expected to: Complete the CCK Volunteer Application to the best of their ability (see attached) Submit a $25 non-refundable program fee along with their application Attend a pre-arranged conference call with CCK on October 4th Respect others in their group and be willing to cooperate in a group in setting Remain flexible, open-minded, and responsible as a representative of the university Attend a CCK “PREconnect” to include orientation, education, and training prior to the trip Attend a CCK “REconnect” to include reflection and celebration following the trip Just as importantly, CCK participants can expect to: Receive transportation, lodging, and meals during the service trip Become better educated about Dravet Syndrome and related medical issues Develop leadership skills such as teamwork, communication, and problem-solving Get connected to future opportunities to serve following their service trip Make lasting memories and gain strong friendships Gain a strong sense of identity and self Have FUN! For more information about the Alternative Service Breaks program, please visit our website: www.ukasb.org. We look forward to having you as a participant on this and future service trips! Sincerely, Alternative Service Breaks and Project Health Page 2 of 5 Alternative Service Breaks Program Information About Alternative Service Breaks Through the Center for Community Outreach and the national service organization Break Away, the Alternative Service Breaks program connects students with service projects in communities beyond the borders of Lexington and Kentucky. We aim to provide service experiences that are educational and cultural, and to promote active citizenship among UK students, faculty, and staff. Our philosophy is that quality community service, particularly service immersion, must involve: 1) strong direct service to address unmet community needs, 2) broad education and deep reflection about social issues facing communities, and 3) exposure to the character and culture of the communities in which we serve. Our approach is deeply rooted in Break Away’s “Active Citizen Continuum” and “Eight Components Of A Quality Break Program,” which include: 1) Strong Direct Service 5) Education 2) Alcohol and Other Drug-Free 6) Training 3) Diversity 7) Reflection 4) Orientation 8) Reorientation Policies and Contracts Payment Plan Policy The Center for Community Outreach operates strictly as a not-for-profit coordinator of Alternative Service Break trips; students are expected to pay the full cost of their service trip and these funds are then distributed to vendors. Thus, it is imperative that participants adhere to the payment plan outlined for their specific service trips. For the CCK weekend service trip, a $25 nonrefundable program fee is due with your application. This will cover the cost of lunch on Friday and your program t-shirt; the Center for Community Outreach will cover all other trip costs. Checks should be paid to the order of “UK Center for Community Outreach”. Please take your program fee and application to the Student Center Ticket Office located in 253 Student Center, open Monday-Friday, 10am-4pm. By signing, I agree to adhere to the payment plan outlined for my service trip, and to pay the full cost of my service trip according to the terms outlined above. Alcohol and Drug Policy As a UK sponsored program, all Alternative Break program participants are bound by the UK Code of Student Conduct for the duration of the program. Specifically, the Alternative Service Break program maintains a strict alcohol and drug free policy aligned with its mission and values. This policy was put in place to: 1) ensure the safety of all group participants, 2) maintain focus on the primary purpose of the trip – service, 3) maintain group cohesion among participants who are diverse in age, and 3) ensure that a group’s presence in the community does no harm. Failure to adhere to this policy may result in my immediate expulsion from the program at my own expense, as well as other legal ramifications and/or disciplinary sanctions through the Dean of Students Office. By signing, I agree to abstain from using alcohol and other drugs for the duration of my service trip. I also understand the possible consequences for my actions should I break this policy. Page 3 of 5 Full Value Contract The Alternative Service Breaks program aims to provide experiences that are educational and cultural, as well as to promote active citizenship among UK students, faculty, and staff. As such, it is imperative that participants engage fully in all aspects of their service trip, and not come late or leave early from the service trip. Being an Alternative Service Breaks participant requires time, energy, and commitment, including meeting requirements before, during, and after the service trip. This may include, but is not limited to PREconnects (orientation, education, and training sessions), REconnects (reorientation meetings or reunion events), service projects, fundraising events, or other gatherings as determined by service trip site leaders. By signing, I agree to invest the time, energy, and commitment required by the Alternative Service Breaks program, in order to ensure that I and others gain value from this experience to the fullest extent possible. Diversity and Inclusion Contract The University of Kentucky is committed to equal opportunity and nondiscrimination in all programs, events, and services, and does not discriminate on the basis of race, color, ethnic origin, national origin, creed, religion, political belief, sex, sexual orientation, marital status, age, veteran status, or physical or mental disability. Likewise, the Alternative Service Breaks program seeks participants representing the diversity of students present at UK, and will engage participants in discussion about issues of diversity and social justice as relevant to each service trip. By signing, I agree to support UK’s commitment to equal opportunity and nondiscrimination by contributing to a climate of mutual understanding and respect. I also agree to actively participate in and contribute to discussions about diversity and social justice as relevant to my service trip. Page 4 of 5 (PLEASE DETACH THE REMAINDER OF THIS APPLICATION TO TURN IN AT THE CSI FRONT DESK) Alternative Service Breaks Policies and Contracts Payment Plan Policy The Center for Community Outreach operates strictly as a not-for-profit coordinator of Alternative Service Break trips; students are expected to pay the full cost of their service trip and these funds are then distributed to vendors. Thus, it is imperative that participants adhere to the payment plan outlined for their specific service trips. For the CCK weekend service trip, a $25 nonrefundable program fee is due with your application. This will cover the cost of lunch on Friday and your program t-shirt; the Center for Community Outreach will cover all other trip costs. Checks should be paid to the order of “UK Center for Community Outreach”. Please take your program fee and application to the Student Center Ticket Office located in 253 Student Center, open Monday-Friday, 10am-5pm. By signing, I agree to adhere to the payment plan outlined for my service trip, and to pay the full cost of my service trip according to the terms outlined above. Alcohol and Drug Policy As a UK sponsored program, all Alternative Service Breaks program participants are bound by the UK Code of Student Conduct for the duration of the program. Specifically, the Alternative Service Breaks program maintains a strict alcohol and drug free policy aligned with its mission and values. This policy was put in place to: 1) ensure the safety of all group participants, 2) maintain focus on the primary purpose of the trip – service, 3) maintain group cohesion among participants who are diverse in age, and 3) ensure that a group’s presence in the community does no harm. Failure to adhere to this policy may result in my immediate expulsion from the program at my own expense, as well as other legal ramifications and/or disciplinary sanctions through the Dean of Students Office. By signing, I agree to abstain from using alcohol and other drugs for the duration of my service trip. I also understand the possible consequences for my actions should I break this policy. Full Value Contract The Alternative Service Breaks program aims to provide experiences that are educational and cultural, as well as to promote active citizenship among UK students, faculty, and staff. As such, it is imperative that participants engage fully in all aspects of their service trip, and not come late or leave early from the service trip. Being an Alternative Service Breaks participant requires time, energy, and commitment, including meeting requirements before, during, and after the service trip. This may include, but is not limited to PREconnects (orientation, education, and training sessions), REconnects (reorientation meetings or reunion events), service projects, fundraising events, or other gatherings as determined by service trip site leaders. By signing, I agree to invest the time, energy, and commitment required by the Alternative Service Breaks program, in order to ensure that I and others gain value from this experience to the fullest extent possible. Diversity and Inclusion Contract The University of Kentucky is committed to equal opportunity and nondiscrimination in all programs, events, and services, and does not discriminate on the basis of race, color, ethnic origin, national origin, creed, religion, political belief, sex, sexual orientation, marital status, age, veteran status, or physical or mental disability. Likewise, the Alternative Service Breaks program seeks participants representing the diversity of students present at UK, and will engage participants in discussion about issues of diversity and social justice as relevant to each service trip. By signing, I agree to support UK’s commitment to equal opportunity and nondiscrimination by contributing to a climate of mutual understanding and respect. I also agree to actively participate in and contribute to discussions about diversity and social justice as relevant to my service trip. ________________________________ Printed Name ________________________________ Signature __________________ Date Page 5 of 5