Winter Student Application

There is no save button. We recommend that you set aside about 30 minutes to complete the application. Students, if you’re applying on your own, please remember there are sections that will require a parent or guardian acknowledgment and signature. Parents or Guardians, if you’re applying for your student, please remember there are specific sections for your student to acknowledge and sign.

1) Student's Personal Information
Nickname
Please give us your current email address.
Please give us the best number for us to reach you at.
Please give us your address.
Please give us your current age.
Please enter as mm/dd/yy
2) Minor Consent

I the parent or guardian of the applying student, understand and agree with “On the Edge” that students, including my own child(ren) and/or who attend public school are being taught about sex from a non-Christian worldview at a very early age. In addition, if my child(ren) are not learning this information at school, they are learning it from their friends and associates, many of which do not have a Biblical perspective on these issues.

It is my desire as a parent to join with On the Edge in educating our youth [including my child(ren) with a solid understanding about what the Bible teaches about purity, sex, marriage, dating, and other related topics including but not limited to topics such as sexuality, gender identity issues, homosexuality, pornography, etc.; as well as any other related questions which may arise from students in attendance that are responded to by the On the Edge staff/speakers/teachers.

I represent that I am the parent or legal guardian of the applying student and by signing this release; I hereby warrant that I have the legal right without limitation to enroll my child into the On the Edge Winter Retreat; and by placing my signature below, I hereby grant my permission to allow the above named Minor to attend and participate in these classes and/or sessions without restriction or limitation. Further, I hereby release and discharge any and all claims, complaints, injuries, damages, disputes and/ or demands against Calvary Chapel Costa Mesa, and its employees, staff, management, volunteers, agents, partners, shareholders, officers, directors, affiliated companies, subsidiary ministries and/or corporations, based on any and all claims, real or imagined, arising out my decision to allow my child(ren) to participate in this program.

In addition, to all of the above, I the parent expressly waive, on behalf of myself and/or my child(ren) all rights under Section 1542 of the Civil Code of the State of California, which reads as follows:

A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH A CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR.

I represent that I am the parent or legal guardian the applying student and by signing this Release; I hereby warrant that I have the legal right without limitation to enroll my child into the On the Edge Murrieta Winter Retreat; and by placing my signature below, I hereby grant my permission to allow the above named Minor to attend and participate in these classes and/or sessions without restriction or limitation.

* Signature is required
3) Medical Information

It is YOUR responsibility to ensure that you have made adequate provision to meet any known medical conditions (i.e. medication, inhalers, epi-pen, etc.) We will be happy to advise on any queries that you or your physician may have prior to your arrival, but we require that you take our medical insurance to cover the period of the program.

A Hospital and Urgent Care are within a 1/4 mile of the facility. You will need to carry your insurance card at all times just in case you need to use it.

For your peace of mind (and ours) we feel it is appropriate to ask you to provide the following personal details to allow us to meet your needs to the best of our ability. This will not affect your acceptance into the program.

Please keep in mind that at this time, our kitchen staff is only able to provide a vegetarian option for meals.
Provide First & Last Name
Medical Consent Form

I, the parent/guardian of the applying student, by signing this form, am stating that I am the guardian, or parent of said student and am entrusting my child to the physical and medical care of the On the Edge staff. I give consent for the following list including, but not limited to:

* Administration of prescribed medication

* Administration of over-the-counter medication or medical staff assessment and supervision

* Emergency medical care provided by local care or emergency department facilities.

By signing this form, I acknowledge that I have read this form and the information provided is complete and accurate.

* Signature is required
5) Release of Liability & Minor Participation Agreement

I represent that I am the parent or legal guardian of the minor participant identified below (hereafter “my child”). By signing this release, I hereby warrant that I have the legal right, without limitation, to enroll my child into the On The Edge Winter Retreat (hereafter “On the Edge”), hosted by Calvary Chapel of Costa Mesa on January 4th 2019 – January 6th 2019 at the Murrieta Hot Springs Christian Conference Center, 39405 Murrieta Hot Springs Rd., Murrieta, CA 92563. By placing my signature below, I hereby grant my permission to allow my child to attend and participate in the On the Edge classes and/or sessions without restric-tion or limitation.

I understand and agree with the “On The Edge” Doctrinal Statement and principles, which include the belief that students, including my child, who attend public school are being taught about sex from a non-Christian worldview at a very early age and that if children are not learning this information at school, they are learning this information from their friends and associates, many of which do not have a Biblical perspective on these issues. It is my desire as a parent to join with On The Edge in educating our youth, including my child, with a solid understanding about what the Bible teaches about purity, sex, marriage, dating, and other related topics including but not limited to topics such as sexuality, gender identity issues, homosexuality, pornography, etc., as well as any other related questions which may arise from students in attendance to which On The Edge staff, speakers, or teachers may respond in order provide students with guidance on these issues.

In consideration of Calvary Chapel of Costa Mesa’s agreement to permit my child to participate in On The Edge, the receipt and sufficiency of which consideration is hereby acknowledged, I, individually, and on be- half of my child and our respective heirs, successors, assigns and personal representatives, agree as follows:

(I) General Liability Release and Indemnification

I understand that there are certain risks, known and unknown, including property damage, bodily
injury and death, which could result from my child’s travel to, from, and participation in On The Edge. I none- theless authorize my child to participate in On The Edge and I agree that my child assumes any and all risks of injury or harm, of any kind, that may be sustained by my child while traveling to, from, or participating in On The Edge. To the fullest extent permitted by law, I fully release and discharge Calvary Chapel of Costa Mesa, its representatives, affiliates, subsidiaries, divisions, members, directors, officers, employees, agents, ser- vants, volunteers, On The Edge staff, On The Edge speakers, On The Edge teachers, owners of the property and property management of Murrieta Hot Springs Christian Conference Center, or any of them (collectively referred to herein as “Calvary Chapel”), from all actions, suits, claims, causes of action, and demands for any injury or harm of any kind whatsoever which may arise from or out of my child’s travel to, from, or participation in On The Edge, however such injury or harm is caused, even if it is caused in whole or in part by action, inac- tion, or negligence of Calvary Chapel. This release is intended to discharge Calvary Chapel against any and all liability arising out of or connected in any way with my child’s travel to, from, or participation in the On The Edge, even though that liability may arise out of the negligence or carelessness on the part of Calvary Chapel.

Should any claim be made or any lawsuit be filed against Calvary Chapel on account of any injury or damage to my child arising from any or related in any way to my child’s travel to, from, or participation in On The Edge, I agree to defend, save, hold harmless, and to fully and completely indemnify Calvary Chapel
for any and all amounts incurred, whether by settlement or judgment, including any amounts incurred by Calvary Chapel in defending against any such claim or judgment, including all attorney’s fees and costs incurred. Moreover, should any claim be made or any lawsuit be filed against On The Edge by any third party on account of the acts or conduct of my child arising from any or related in any way related to my child’s travel to, from, or participation in On The Edge, I further agree to defend, save, hold harmless, and to fully and completely indemnify Calvary Chapel from any and all amounts incurred, whether by settlement or judgment, as well as any amounts incurred by Calvary Chapel for defending against any such claim or judgment, including all attorney’s fees and costs incurred.

This general liability release and indemnity agreement shall apply to all known, unknown and/or unanticipated injuries and damages resulting from or during my child’s travel to, from, or participation in On The Edge from any cause whatsoever. I EXPRESSLY WAIVE THE PROVISIONS OF SECTION 1542 OF THE CIVIL CODE OF THE STATE OF CALIFORNIA AND ANY SIMILAR PROVISIONS OF THE LAWS OF ANY OTHER JURISDICTION, WHICH READS AS FOLLOWS:

“A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor.”

(II) Authorization for Third Party Consent to Medical Treatment

I give my informed consent to allow Calvary Chapel and any First Aid personnel assigned by
Calvary Chapel, to provide basic First Aid and comfort measures to my child through standardized treat- ment procedures which includes the use of over-the-counter medications. I authorize HCF to provide my child with the following generic, over-the- counter medications as directed by the labels provided by the manufacturer: analgesics, decongestants, antihistamines, cough suppressant and/or expectorants, throat lozenges or spray, anti-nausea/diarrhea, antacid, antibiotic ointment, hydrocortisone cream, burn cream, petroleum jelly, chapped skin/lip treatment, antiseptic skin and wound cleansers, ipecac, glucose, laxa- tives, electrolyte replacement fluids, analgesic balms and gels.

I authorize Calvary Chapel to arrange for or provide any necessary transportation for my child to the near- est medical facility for urgent or emergency medical treatment, if indicated, and I assume all responsibility for payment for such treatment. I acknowledge that my child has his or her own medical and dental insur- ance and I fully and unconditionally release and indemnify Calvary Chapel from all liability for any medical or dental treatment rendered to my child. I hereby authorize and consent for my child to receive any x-ray, examination, anesthetic, medical or surgical diagnosis rendered under the general or special supervision of any member of the medical staff and emergency room staff licensed under the provisions of the Medicine Practice Act or a dentist licensed under the provisions of the Dental Practice Act and on the staff of any acute general hospital holding a current license to operate a hospital from the State of California Department of Public Health.

I understand that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power to render care to my child to which the aforementioned medical and dental professionals in the exercise of their best judgment may deem advisable. I understand that every effort shall be made to contact me prior to rendering any treatment to my child, but that any of the above treatment will not be withheld if I cannot be reached. This authorization is given pursuant to the California Family Code section 6910, and similar provisions of the laws of the State or Country in which the medical or dental care is being sought.

I hereby authorize any hospital, medical facility, other medical or dental provider who has provided treatment to my child to surrender physical custody of my child to Calvary Chapel upon the completion of treatment. This authorization is given pursuant to Section 1283 of the Health and Safety Code of California, and similar provisions of the laws of the State or Country in which the medical or dental care is being provided.

These authorizations shall remain effective through the dates set forth above for the On the Edge Summer Program, unless sooner revoked in writing.

(III) Video/Photo Release

During On the Edge, photographs may be taken and videos may be produced and used for future publicity. I give permission for photographic images and video’s of my child captured during On The Edge, to be used for the purposes of Calvary Chapel, including in promotional materials and publica- tions and I waive any rights of compensation or ownership thereto.

(IV) Other Acknowledgements

I understand and acknowledge that On the Edge is intended to provide encouragement, guidance and teaching for those with a genuine desire to grow in their walk and seek the Lord’s direction for their life.

I further understand and acknowledge that my child is required to recognize the leadership and oversight of the On The Edge pastoral team, as well as to abide by all On The Edge Rules & Guidelines. I understand that, should my child fail to support these intentions, fail to follow the On The Edge Rules & Guidelines, or fail to follow instructions of the Conference Center and Bible College Staff, Calvary Chapel reserves the right to remove my child from On The Edge.

No oral representatives, statements, or inducements have been made by or between the parties to this Agreement with respect to the subject matter of this Agreement apart from the matters set forth within this Agreement.

In signing this Agreement, I hereby acknowledge and represent that I have read this entire document, that I understand its terms and provisions, that I understand it affects my legal rights and those of my child, that it is a binding Agreement, and that I have signed it knowingly and voluntarily.

THIS IS A RELEASE OF YOUR RIGHTS. READ CAREFULLY BEFORE SIGNING.

* Signature is required
6) Doctrinal Statement

We believe that there is one living and true God, eternally existing in three persons: The Father, the Son, and the Holy Spirit, equal in power and glory; that this triune God created all, upholds all, and governs all things. (Genesis 1:1; Deuteronomy 6:4; Isaiah 44:8 and 48:16; Matthew 28:19-20; John 10:30; Hebrews 1:3).

We believe that the scriptures of the Old and New Testaments are the Word of God, fully inspired without error and the infallible rule of faith and practice. The Word of God is the foundation upon which this ministry operates and is the basis for which this min- istry is governed. We believe that the Word of God superseded any earthly law that is contrary to the Holy Scriptures. We believe that the King James Version of the Bible is the most accurate translation from the original ancient text. It is from the translation that we establish our doctrine and Statement of Faith. (Isaiah 28:13; Nehemiah 8:8; John 17:17; 2 Timothy 3:16-17; Hebrews 4:12; 1 Peter 1:23-25; 2 Peter 1:3-4 and 1:21).

We believe in the person of God the Father, an infinite, equal, personal Spirit, perfect in holiness, wisdom, power and love; that He concerns Himself mercifully in the affairs of men that He bears and answers prayer; and that He saves from sin and death all those who come to Him through Jesus Christ (Deuteronomy 33:27; Psalm 90:2; Psalm 102:27; John 3:16 and 4:24; 1 Timothy 1:117; Titus 1:3).

We believe in the person of Jesus Chris, God’s only begotten Son, conceived by the Holy Spirit. We believe in His virgin birth, sin- less life, miracles and teachings. His substitutionary atoning death, bodily resurrection, ascension into heaven, perpetual interces- sion for His people and personal, visible return to earth. (Isaiah 7:14; Micah 5:2; Matthew 1:23; Mark 16:19; Luke 1:34-35; John 1:1-2; 8:58 & 11:25; 1 Corinthians 15:3-4; 1 Timothy 3:16; Hebrews 1:8; 1 John 1:2; Revelation 1:8).

We believe in the person of the Holy Spirit. Who came forth from the Father and Son to convict the world of sin, righteousness, and judgment , and to regenerate, sanctify and empower for ministry all who believe in Christ; (Acts 1:8; 2 Corinthians 3:18; John 16:8-11; Romans 8:26 and 15:13,16; Hebrews 9:14).

We believe the Holy Spirit indwells every believer in Jesus Christ and that He is an abiding helper, teacher, and guide. (John 6:13; 14:16-17 and 18:8-11; Romans 8:26).

We believe in the present ministry of the Holy Spirit and in the exercise of all Biblical gifts of the Spirit according to the instruction given to us in 1 Corinthians 12-14 (1 Corinthians 14).

We believe that all people are sinners by nature and, therefore, are under condemnation, that God saves and regenerates based upon faith by the Holy Spirit, those who repent of their sins and confess Jesus Chris as Lord. (Acts 8:15-17; Ephesians 2:1-3 and 8-8; Romans 3:23 and 5:8; Titus 3-5).

We believe in the universal church, the living spiritual body, of which Christ is the head and all who are born again are a apart of the Body of Christ. (1 Corinthians 12:12-13; Ephesians 4:15-16)

We believe that the Lord Jesus Christ instituted two ordinances for the church: (a) full immersion water baptism of believers, and (b) the Lord’s Supper. (Matthew 28:19, Luke 22:19-20, Acts 2:38; 1 Corinthians 11:23-26) We also believe that the Lord Jesus Christ validated the ordinance of marriage. (Matthew 19:4-5 and john 2:1-11)

We believe in the Second Coming of Jesus Chris, which is His personal, visible return to earth and establishment of His millennial kingdom, in the resurrection of the body, the final judgment and eternal blessing of righteousness and endless separation of the wicked. (Matthew 16:27; Acts 1:11; Revelation 19:11-16; 20:11-15)

We believe in the Pre-Tribulation Rapture of the Church were all believers will meet the Lord in the air and be taken out of this world priory to the Tribulation that will come upon the earth. (Isaiah 26:20; Matthew 24: 29-31; Luke 21:36; Romans 1:18, 5:9; 1 Thessalonians 1:10, 4:13-16 & 5:9, 2 Peter 2:7-9, Revelation 3:10, 5:7-10 and 7:13-14)

We believe in a literal Heaven and literal Hell and that all those who place their faith, hope and trust in Jesus Chris will spend eternity in Heaven with the Lord, while those who reject Jesus’ free gift of salvation will spend eternity separated from the Lord. (Psalm 9:17; Matthew 5:3, 5:22, 18:9, and 25:13-34; Mark 9:42-49; Luke 12:5; John 3:18; Hebrews 12:23; 1 Peter 1:4; Revelation 14:10-11

* Signature is required
7) On the Edge Rules and Guidelines

1. Students are expected to be an example of Christ in all their behavior.

2. Students will be expected to avoid the distraction of close relationships with the opposite sex during the duration of the retreat.

3. Students are required to be prompt and attend everything that is scheduled.

4. No tobacco, drugs, and/or alcohol.

5. No weapons.

6. No electronics during sessions or workshops.

7. No co-ed swimming in the Roman Spa & Hot Springs.

8. No leaving property without a counselor or staff member.

9. No girls in guys rooms and vice versa.

10. No food or drinks in lodges.

11. Students are required to respect all Conference Center and Bible College Staff.

 

I, the applying student, have read and agree to adhere to and obey all rules.
* Signature is required
I, the guardian or parent of the applying student, have read and understood the rules. My child is responsible to adhering to. Any disobedience or breaking of the rules may result in the dismissal of the student.
* Signature is required
8) What to Bring

CLOTHES

  • Shirts
  • Athletic Clothing
  • Jeans
  • Tennis shoes
  • Swimsuit
  • Tank tops
  • Undergarments
  • Socks

TOILETRIES

  • Shampoo and conditioner
  • Soap
  • Toothbrush/Toothpaste
  • Deodorant
  • Sunscreen
  • Towel

SCHOOL SUPPLIES

  • Bible
  • Notebook
  • Journal
  • Pen
  • Pencils
  • Highlighter
  • WILLING and TEACHABLE heart

9) Please DO NOT BRING:

  • Weapons
  • Drugs/tobacco products
  • Alcohol
  • Game consoles
  • Pornographic material

10) Travel Arrangements

Each student is responsible for transportation to and from Murrieta Hot Springs Christian Conference Center. Please make sure that your arrival and departure dates coincide with the dates listed below.

Arrival: January 4, 2019 (8am-3pm)

Departure: January 6, 2019 (1pm-5pm)

11) Current Photo of Student
Please take a moment to upload a current photo of the applying student. It can be from a mobile device.