2016 ROCKY MOUNTAIN WINTER BLAST
EAST SLOPE
FEBRUARY 5-6, 2016
Hey Children’s Leaders!
We are so excited your church is considering attending the Eastern Slope RMMN Kids Winter
Blast this year. This is a one night event for ALL kids K-5th grade from across the Rocky Mountain
Network to come together and experience our awesome God while making great & fun memories.
This year, we will be hosting this event in Thornton, CO at Rock AG Church. We are planning a
night of fun, food, worship, small groups, alter time, and an awesome late night activity at Jump City
that the kids are sure to enjoy and remember.
Below is a general timeline of the event so know what to expect at Winter Blast:
Saturday February 6th
Friday February 5th
5:00-5:45pm
5:45 pm
6:45 pm
7:15 pm
9:00 pm
1:00 am
1:00 am
1:30 am
Arrive @ Winter Blast
Dinner
Games
Service
Late Night Activity @ Jump City
Arrive @ RAG from Jump City
8:00 am
9:00 am
9:30 am
10:00 am
10:20 am
Breakfast & Pack-up
Breakout Session 1
Breakout Session 2
Farewell Service
Depart Winter Blast
Prep for Bed
Lights Out
Boys & girls will be sleeping in separate areas overnight, so your church needs to supply enough
adult leaders for the amount of kids registered for your church, including both male & female
chaperones. We ask each church to screen every leader that attends Winter Blast, and complete the
included staff application & reference forms. We are charging $5 per adult staff your church brings, and
we encourage your church to pay that fee for each adult staff.
Your church also needs to supply/coordinate transportation to and from our late night activity at
Jump City in Westminster. If you need to increase the price per child to cover your transportation cost,
there is a line available on the brochure for you to do so.
Lastly, we are here to help make this event as great as possible for the kids of your church.
Please call or email us with any Winter Blast questions or concerns and we will be happy to help.
Austin & Brook Jackson
Winter Blast Event Directors
Kidz Ministries Directors at Rock AG Church
303-518-8857
austinj@rockagchurch.com
brookj@rockagchurch.com
2016 ROCKY MOUNTAIN WINTER BLAST
EAST SLOPE
FEBRUARY 5-6, 2016
REGISTRATION PROCESS
REGISTRATION
1. Brochures
a. Set a deadline for registrations & waivers to come be turned into your church office.
1. Our Recommended Deadline: January 24
b. If your Church is adding a transportation fee (cost for transportation to & From Rock AG Church,
and to & from Jump City) to each child’s registration: Please add that amount to the registration
cost on the brochure.
c.
Copy and distribute the brochures & Jump City Waivers.
2. Collect all child registration forms and money.
a) Make sure parents have signed them.
b) Have parents make checks payable to your local church.
c) Collect a Jump City Waiver for EACH Child.
3. Mail the church’s registrations to the District Office by JANUARY 25.
a) Each church’s registration must be postmarked by JANUARY 25.
Send to:
Kids Winter Blast-East Slope
Rocky Mountain District Council
6295 Lehman Dr Suite 202
Colorado Springs, CO 80918
PLEASE INCLUDE:
A. Registrations for each child.
B. Staff Application / Pastoral Reference for each staff member.
C. Financial Worksheet (last form).
D. A church check payable to RMMN (Rocky Mountain Ministry Network)
a. Amount needs to total $15 per child and $5 per each adult
b. Money is non-refundable
CHECKIN
1. One staff member will check-in group upon arrival at Rock AG Church in Thornton.
2. In registration the adult will:
1. Verify that all kids and staff are present
2. Turn in Lice Check Acknowledgment
3. Receive name tags, wristbands, room assignments, etc.
3. After registration, the adult will give each kid their name tag and related items.
4. All medications (kid & staff) must be submitted to the on-site nurse.
Please NOTE
Each Church is responsible to provide transportation from Rock AG Church to Jump City and back to
Rock AG Church for the late night activity on February 5th. Add any necessary fees to each child’s
registration cost on their brochure.
NOTICES For Winter Blast 2016
1. REGISTRATION CLOSES ON JANUARY 25.
ALL REGISTRATIONS MUST BE MAILED AND/OR
POSTMARKED TO THE DISTRICT OFFICE BY
JANUARY 25.
2. CHURCHES NEED TO SUPPLY ADULT STAFF.
Churches are encouraged to send enough staff to monitor the children that each church
is bringing. This should include at least 1 male & 1 female staff member, and more
depending on the size of the group of kids each church brings.
3. CHURCHES ARE REQUIRED TO SCREEN
EACH STAFF MEMBER.
We are relying on the local churches for the screening of their staff. Please make sure
that your workers are properly screened prior to attending Winter Blast. On the Pastoral
Reference form included in this packet it will ask you to verify that your workers have
been screened and provide us with the date of that screening.
Please NOTE
Each Church is responsible to provide transportation from Rock AG Church to Jump City and
back to Rock AG Church for the late night activity on February 5th. Add any necessary fees to
each child’s registration cost on their brochure.
WINTER BLAST
STAFF APPLICATION
ROCKY MOUNTAIN
MINISTRY NETWORK
EAST SLOPE
KIDS WINTER BLAST, EASTERN SLOPE, THORNTON CO,
FEBRUARY 5-6, 2016
.
Please give this form to your children’s pastor or coordinator by January 24th.
SPECIAL QUALIFICATIONS AND SKILLS
_____ADVANCED FIRST AID
_____EMT
_____SPORTS _____LEADING WORSHIP/SONGS
_____LEAD SMALL GROUPS _____PUPPETS
_____DRAMA
_____MUSIC
_____BIBLE QUIZ
_____SCIENCE _____CRAFTS _____VIDEO
_____OTHER_________________________________
PERSONAL INFORMATION
Name____________________________________________
Sex: Male Female Birthdate____________
Address__________________________________________
City_______________ State____ Zip________
Home Phone_______________________________________
Email_________________________________
Occupation________________________________________
Work Phone____________________________
Home Church______________________________________
City__________________________________
How long have you attended the above church?___________
Member: Yes No
Have you asked Jesus to be your Savior? Yes No
Have you been baptized in the Holy Spirit? Yes No
MEDICAL INSURANCE
Insured by________________________________________
Policy #_______________________________
Insurer’s Address__________________________________________________ Phone______________________
Notes: Camp insurance covers only accidents at camp. Preexisting conditions are not covered.
Camp insurance is secondary insurance, covering only what your personal insurance does not cover.
KIDS/YOUTH CAMP EXPERIENCE
Camper?
Yes No
Years_______________ Where___________________________________
Camp Staff?
Yes No
Years_______________ Where___________________________________
Duties________________________________________________________________________________________
PERSONAL
Spouse’s name____________________________________
In case of emergency, contact________________________________________ Phone______________________
Do you have any disabilities or limitations? Yes No
If yes, please explain_____________________________
CONFIDENTIAL INFORMATION
Have you ever been convicted of a felony or any other crime, other than traffic violations? Yes No
If yes, please explain__________________________________________________________________________
Have you ever been convicted of a drug related charge or had charges reduced in a plea bargain? Yes No
If yes, please explain__________________________________________________________________________
Have you ever physically or emotionally abused a child? Yes No
If yes, please explain__________________________________________________________________________
Have you ever been dismissed from employment or a volunteer position in a child supervisory capacity? Yes No
If yes, please explain__________________________________________________________________________
Will you give the Rocky Mountain District of the Assemblies of God permission to do a confidential criminal
background check on you? Yes No
In signing this application you are agreeing to a random drug screening test and release of all criminal records.
REFERENCES
Please give the names and addresses of two mature, non-related Christian friends.
In additional to those names, please have your pastor complete the “Pastor’s Reference Form.”
Name____________________________________ Name____________________________________
Address__________________________________ Address__________________________________
__________________________________
__________________________________
Phone____________________________________ Phone___________________________________
I pledge myself to a week of cooperative ministry with the directors and staff of the Rocky Mountain Camps.
I will abide by all rules and will maintain a Christ-like attitude. I will also do whatever is asked cheerfully.
Signature___________________________________________ Date_____________________________________
PASTORAL REFERENCE
ADULT STAFF – WINTER BLAST – EAST SLOPE, FEBRUARY 5-6, 2016
.
STAFF APPLICANT’S NAME_____________________________________________________________________
The above named person has applied to attend the Winter Blast-East Slope on February 5-6, 2016.
We would appreciate your CONFIDENTIAL comments on the applicant.
Since it is impossible for us to become personally acquainted with all the applicants, we must rely heavily upon your
recommendation. Please complete this evaluation and return it to us, as soon as possible. The candidate’s
application cannot be processed without this reference form. Thank you for your assistance.
RETURN TO:
Kids Winter Blast–East Slope
Rocky Mountan Ministry Network
6295 Lehman Dr Suite 202
Colorado Springs, CO 80918
1.
Do you believe the applicant to be a well-grounded Christian? Yes_____ No_____
_________________________________________________________________________________________
_________________________________________________________________________________________
2. Does the applicant attend your church? Yes_____ No_____ How long?___________________________
3. Describe the applicant’s involvement in local ministry. ______________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
4. To the best of your knowledge, has the applicant been charged with or convicted of a felony? ______________
_________________________________________________________________________________________
_________________________________________________________________________________________
5. What leadership qualities has he/she evidenced? _________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
6. The applicant will be in direct contact with children. To the best of your knowledge, is there anything in the
applicant’s past or character that would cause you to question their ability to be used in this capacity? ______
_________________________________________________________________________________________
_________________________________________________________________________________________
7. Have you completed a criminal background search on this applicant? Yes_____ Date Completed_________
8. Does he/she have any emotional, mental, or physical handicaps? _____________________________________
_________________________________________________________________________________________
9. To the best of your knowledge, does he/she use drugs, alcohol, tobacco, or has he/she been charged or
convicted for illegal use of these items? _________________________________________________________
_________________________________________________________________________________________
10. Would you recommend him/her to work with children, without reservation? Yes_____ No_____
CHECK THE FOLLOWING:
Spiritual depth and maturity
Dedication to Christ
Christian standards
Ability to get along with others
Follows through on instructions
Cooperation
Teachability
General attitude
Disposition
Health
General appearance
Faithfulness
Excellent
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Good
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Fair
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Poor
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COMMENTS:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
SIGNATURE __________________________________________________
Date __________________________
Print your name ________________________________________________ Church ________________________
Phone ________________________
2016 RMMN KIDS WINTER BLAST – EASTERN SLOPE
FINANCIAL WORKSHEET
(Send completed form, registration forms and payment to
the RMMN by JANUARY 25)
Church Name__________________________________________ City__________________
Children’s Leader Attending Winter Blast___________________________________________
Email Address: ____________________________________________________
Total Number of Kids
________ x $20.00 =
$__________
Number of adult staff
________ x $5.00 =
$__________ (add)
CHURCH TOTAL
=
Send the form and a check with the total to RMMN by JAN 25 =
BALANCE (should be 0)
To be completed by Event Staff:
NOTES:
=
$ __________
$ __________ (subtract)
$ __________