NIKO

PARTICIPANT

PREPARATION

PACKET

Dear NIKO Participant,

“NIKO” is a Greek word pronounced, “nee-ko.” It means, “to subdue, conquer, overcome, or prevail against.”

In a NIKO you learn in the classroom of life by “doing” instead of simply absorbing dry information. This “hands-on” experience teaches you to grow in the interdependence of a team. Through the NIKO experiences you will begin to understand more about yourself and the gifts that God has given to you. You will begin to learn what motivates you, as well as your unique style of leadership. A high priority is placed upon teamwork and perseverance. You will be challenged to increase your initiative, creativity, compassion, responsibility, and confidence through serving others.

A NIKO will challenge you to discover your mental, physical, spiritual, and emotional strengths and weaknesses. Your relationship with God and others will be tested and/or proven through this experience and its physical challenges. You will learn to confront issues of leadership and personal identity. You will be required to face and overcome many obstacles that will be encountered in life’s future decisions.

During NIKO you will work with other young people towards a common goal. The support and inspiration of friends and compassionate Christian instructors will allow you to push past the limits you may have previously set for yourself, allowing you to draw nearer to God.

How to prepare:

The NIKO is a PHYSICAL program involving a variety of different levels of exercise; participants should be in good physical shape. Listed below are some sample exercises that will help you prepare for the NIKO (aerobic sports [running, soccer, etc.] are also encouraged). You should start slowly and work your way to a more intense workout as your muscles develop. Please do not bring new hiking boots, unless they are well broken in, as this will cause your feet to develop blisters when hiking. Get in shape now or you will be SORE-Y!

             1. Crunchies

             2. Push-ups and Pull-ups

             3. Jump Rope

Please read through the enclosed packet carefully. Also, please complete and return all forms to the NIKO Office you are associated with along with the NIKO fees. You need to bring all items listed on the packing list that your leader will give you. Please contact us if you or your parents have any questions regarding the NIKO. Thank you.

In Christ,

The NIKO staff

NIKO OBJECTIVES

 “No, in all these things we are more than conquerors through Him who loved us.”  Romans 8:37

A.   Learn how to work creatively, effectively, and safely in a team environment

B.   Grow in decision making and problem solving skills

C.   Learn how to enjoy and respect the beauty of God’s Creation

D.   Take responsibility for your actions and their sequential rewards or consequences

E.   Recognize and value yours and other’s strengths and weaknesses

F.   Learn the value of encouragement

G.   Overcome self-imposed physical, mental, emotional, and spiritual obstacles

H.   Learn how to trust God and others

I.     Learn how to submit to leaders and also serve others as a leader

J.    Enjoy the rewards of reaching goals you thought were unattainable

K.   Contentment in a variety of circumstances regardless of momentary discomfort

L.    Recognize and value your personal worth as a child of God

NIKO APPLICATION

MEDICAL RELEASE

I/we hereby grant permission for the performance of any emergency treatment that may be required in the case of an accident or illness wherein I am rendered unconscious or unable to approve of the required medical treatment. Or as a parent/guardian, I give permission for said treatment to be given to my minor child.

___________________________________________________________________

Signature of Participant                                 Printed                             Date

Address_______________________________________________________________

Witnessed By___________________________________________________________

Minor Parent’s/Guardian’s Signature__________________________________________

MEDICAL HISTORY

ILLNESSES OR INJURIES (Check all that apply)

(All medical information is confidential and extremely important for your safety.)

Chronic or Recurring Illness___  Asthma *___   Ear Infection___   Kidney___

Epilepsy___  Convulsions___   Diabetes___   Heart Disease___   Other___

*If you have asthma and require an inhaler you must carry yours with you. You will not be allowed to participate without it.

Date of Last Health Examination___________________________

Were there any complicating medical problems noted during this exam?___________

Are you currently under a physicians care?___________________________________

Since your last health examination have you had a serious injury?________________

....an illness lasting longer than a week?______________________________________

....a surgical operation or fracture?__________________________________________

....treatment in a hospital as an inpatient or in the emergency room?______________

....medication prescribed by a physician or in the emergency room? ______________

Please list condition, dosage, and duration.  _________________________________
(In case of an emergency this information is very important.)

Is your minor restricted from participation in any school physical education activity?

OTHER HEALTH CONDITIONS (Check all that apply)

Menstrual Cramps___   Constipation___   Nosebleeds___   Motion Sickness___

Emotional Disturbances___   Sickle Cell Anemia___   Fainting___ Hearing Impaired___  

Special Dietary Regime___  Contact Lenses___   Glasses ___Sleep Walking___

Have you ever been exposed to or do you carry any contagious diseases or infections? _____________________________________________________________________

Allergies (Specify)__________________________

If you have a severe allergic reaction to bees you must carry your own epinephrine pen on you at all times.  You will not be allowed to participate without it.

Food Allergies__________________

Are you allergic to any medications? __________________________________________

Please explain any “yes” answers to the above questions. Indicate any useful information to the adult in charge in relation to any of these health conditions. Also, indicate any activities to be encouraged or restricted. Use another sheet if necessary

___________________________________________________________________

SALEM KING’S KIDS/NIKO MEDICAL RELEASE FORM

Name___________________________________________________________

Home address__________________________________________________________

Phone #_(_____)_______________________________________

Sex__________ Age_____ Height___________ Weight_________

I/we, the parent(s) or guardian approve of the applicant’s participation in the NIKO and fully understand its rigorous nature.

Parent’s Signature_____________________________________

Printed______________________________________________

Health and Accident Insurance Coverage Policy Number_______________________________________________

Person to Be Notified in Case of Emergency_______________________________________________________

Address____________________________________________________________

Day Phone_________________________________

Evening Phone______________________________

                   RELEASE FROM LIABILITY

In consideration for BOISE CASCADE CORPORATION allowing the YOUTH WITH A

MISSION GROUP to use the Boise Cascade Corporation forest lands in Polk County, State of

Oregon ("Premises") on __________________, the undersigned agrees to the Following:

            1.Hold Harmless And Indemnification: The undersigned agrees to indemnify and hold Boise Cascade Corporation, its employees, officers, and affiliates harmless from and against all loss, damage, or liability which is caused by or arises out of, or is claimed to have been caused by or to have arisen out of the undersigned's use of the Premises.  The undersigned shall, at its own cost and expense, defend any such claim, suit, action, or proceeding which may be commenced. against Boise Cascade Corporation due to the undersigned's use of the Premises.  In addition, the undersigned shall pay any and all judgments which may be recovered in any such action, claim, proceeding, or suit and shall pay for any loss and all expenses which may be incurred by reason thereof

            The undersigned hereby agrees that Boise Cascade Corporation shall not be liable to the undersigned for any claim of loss or damage to the undersigned's person or property, and loss or damage to any third person's property or any of Boise Cascade Corporation's employees or agents which may be asserted against Boise Cascade Corporation in connection with the undersigned's use of the Premises.

            2. Liability For Damages To Premises: The undersigned shall be responsible for any damage done to the Premises whenever such damage arises out of or is claimed to have arisen out of the undersigned's use of the Premises.

            3.Guests And Children: The undersigned hereby extends all of the above indemnities and waivers to Boise Cascade Corporation set forth above in respect of any minors or any other guests brought on the Premises by the undersigned.

Name (Printed); Signature **___________________________________________________

Address________________________________________________         

________________________________________________

Telephone______________________________________________

Club Youth With A Mission Salem, Oregon (NIKO Department)

Date___________________________________________________

** Parents of minors must sign

PARENTAL AGREEMENT (to be filled out only by Parents of minors)

a.         I/we are aware of the fact that KING’S KIDS/NIKO will not take financial responsibility for sickness, accident, loss or damage of property, or any unforeseen events.

b.         In consideration of allowing my child to participate in the above mentioned activity, we the undersigned, as parent(s)/guardian(s), covenant with YOUTH WITH A MISSION and KING’S KIDS/NIKO, including each of their employees, staff members, agents, and volunteer workers, hereafter collectively referred to as “KING’S KIDS/NIKO,” that I will never individually or jointly, or on behalf of my minor child, institute or assist in any action at law in any court, tribunal, or other forum against KING’S KIDS/NIKO on account of any injury or other loss or damage of any kind whatsoever that may hereafter be sustained by my minor child named above or myself as a consequence of said minor’s or my participation in, or involvement in any activity either in a training center, outreach, outing, transportation to or from any activity by bus, van, automobile, boat, airplane, public or private conveyance, or otherwise, sponsored directly or indirectly by KING”S KIDS and any affiliated agencies, or representatives, whatsoever.

c.         This covenant shall bind me and my heirs, assigns and legal representatives and may be pleaded as a complete defense to any action brought in breach of this covenant and agreement, and I expressly agree to indemnify KING’S KIDS/NIKO against, and to pay any loss from me or by anyone in my behalf, or on behalf of themselves, or in said minor’s behalf, for the purpose of enforcing a claim for loss of life, personal injury, property damage, or loss sustained by me or them or said minor in consequence of my, or their, or minor’s attendance or participation in any KING’S KIDS/NIKO activity of any kind whatsoever.

d.         I/we have read this agreement and understand all its terms to my/our complete
satisfaction and have executed this document freely and with full knowledge of its legal significance.

SIGNATURES OF PARENTS OR LEGAL GUARDIANS

________________________________________________       _______________

Name                                                                                                               Date

________________________________________________       _______________

Name                                                                                                               Date

SIGNATURE OF WITNESS

________________________________________________       _______________

Name                                                                                                               Date

Participant Agreement

(To be filled out only by participants over 18 years of age.)

e.         I am aware of the fact that KING’S KIDS/NIKO will not take financial responsibility for
sickness, accident, loss or damage of property, or any unforeseen events.

f.          In consideration of participating in the above mentioned activity, I the undersigned,
covenant with YOUTH WITH A MISSION and KING’S KIDS/NIKO, including each of their employees, staff members, agents, and volunteer workers, hereafter collectively referred to as “NIKO,” that I will never, institute or assist in any action at law in any court, tribunal, or other forum against NIKO on account of any injury or other loss or damage of any kind whatsoever that may hereafter be sustained by my myself as a consequence of my participation in, or involvement in any activity either in a training center, outreach, outing, transportation to or from any activity by bus, van, automobile, boat, airplane, public or private conveyance, or otherwise, sponsored directly or indirectly by NIKO and any affiliated agencies, or representatives, whatsoever.

g.         This covenant shall bind me and my heirs, assigns and legal representatives and
may be pleaded as a complete defense to any action brought in breach of this covenant and agreement, and I expressly agree to indemnify NIKO against, and to pay any loss from me or by anyone in my behalf, or on behalf of themselves, for the purpose of enforcing a claim for loss of life, personal injury, property damage, or loss sustained by me in consequence of my attendance or participation in any NIKO activity of any kind whatsoever.

h.         I have read this agreement and understand all its terms to my complete satisfaction and
have executed this document freely and with full knowledge of its legal significance.

Signature participant

_______________________  _______________________       _______________

Name                                        Printed                                          Date

Signature of Witness

_______________________  _________________________       _______________

Name                                          Printed                                                          Date

Directions From I-5 to YWAM Salem’s Campus

From I-5 South Bound (from the north)

Take Exit 252 Kuebler Blvd.

Turn right

Follow Kuebler to Battle Creek, this will be the first light after you turn

Make a left on Battle Creek

Our Salem Campus is about three miles down the road on the right, look for the big sign.

From I-5 North bound (from the south)

Take the Kuebler exit #252

Turn left on Kuebler

Battle Creek will be the second light after your turn

Turn left on Battle Creek and follow it about three miles