generation revive short-term missions application

7/28/2019 Generation Revive Short-Term Missions Application

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Generation Revive Short-Term Missions Application

Full name: ________________________________________________________

Address _______________________________________________________________

City _____________________ State _________ Zip________

Home Phone: _________________ Cell Phone_________________

Email: __________________________________Fax:________________________

Age: _______ Birthdate: ___/_____/______ Citizen of (Country): ________________

Birthplace: ____________________(Country)

Passport Number: ______________________________ Issue Date: _______________

Exp.Date_______________

Marital Status: (Circle) Single Engaged Married Separated Divorced

Spouses Name: __________________________________

Mission Destination: __________________________ Date: _________________

Church ServiceCurrent church you attend

____________________________________________________________________Address

____________________________________________________________________

City ________________________________ State _________ Zip _____________

Are you a member? Yes ____ No____

Pastor/Priests name _________________________

PERSONAL INFORMATION

1. Please describe how and when you came to know the Lord:

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________


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2. Have you come to the place in your own spiritual life where you know for certain

that, if you died today, you would go to heaven? Yes ____ No____

3. We believe first and foremost that Jesus Christ is the only way to the Father. We

want to provide an atmosphere that is in agreement with the workings of the Holy

Spirit. This includes, but is not limited to: healing, tongues, prophecy, andbreakthrough. The Gospel according to the Bible is what we believe is the

cornerstone for every Christian life, and the building block of revival.

A. Do you agree that the bible is the Holy and inerrant authoritative word of God?

Yes ____ No____

B. Do you believe that the Spirit of God is active today, and desires to use you and this

group to change the world? Yes ____ No____

4. Why do you want to go on a mission trip?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

5. Do you serve in any volunteer/leadership role in any ministry or outside the church?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

6. Have you ever served on a mission trip, or had any cross-cultural experience? If

yes, where and when?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

7. How does your family feel about you going on this trip?

______________________________________________________________________

______________________________________________________________________

8. Have you ever been convicted of committing a crime? Yes___ No___ If yes, explain:

______________________________________________________________________

______________________________________________________________________

9. If you are applying for a trip that includes ministry to children, you may be required

to have a background check. Will you agree to a check? Yes___ No___


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REFERENCES

Please provide the contact information of one person who knows about your values and

character.

Name: __________________________ Relationship: ___________________

Phone: ____________________ Email: _________________________

HEALTH INFORMATION:

1. Do you have or have you ever had:

(Circle)

Fainting Spells? Heart Problems? Diabetes?

Eating Disorder? Respiratory Problems? Seizures?

2. Do you have any condition which might affect your ability to fully function as a

missionary on this trip (i.e., fear of flying, anxiety, sleeping disorders)?

________________________________________________________________________

3. Do you have any chronic illnesses or allergies? Yes___ No___ If yes, explain:

_________________________________________________________________________

_________________________________________________________________________

4. Are you presently under medication prescribed by a doctor? Yes___ No___ If yes,

explain:_________________________________________________________________________

_________________________________________________________________________

6. Please list any hospitalization history:

_________________________________________________________________________

_________________________________________________________________________

7. Does your health insurance cover you overseas? Yes___ No___

8. How would you describe your health and fitness?

(Circle)

Excellent? Good? Average? Needs work?

We desire, not require, that participants be in good to average shape, in order to be used to

the fullest of their potential.


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WAIVER AND RELEASE OF LIABILITY

I, ______________________________ (team members name) plan to participate in a

short-term mission trip to __________________ and understand the actual itinerary and

the actual activities that I participate in during the short-term mission trip may vary. I

recognize the participation in the short-term mission trip and its activities maybe hazardous

and dangerous, and I willingly assume all risks associated with the short-term mission trip.

I acknowledge that I have been advised to seek my medical professional to understand the

potential for contracting disease or parasites or suffering other adverse health consequences

during my participation in short-term mission trip. I understand that such diseases parasites

or health conditions may cause or result in serious health problems and may be fatal. I also

realize that I will be serving in a country less developed than the United States, one that

may report cases of diseases more frequently than in the Unites States such as malaria,

yellow fever, typhoid, Hepatitis A Hepatitis B and/or other diseases or illnesses.

I am aware that Generation Revive requires me to obtain Tetanus Vaccinations and

strongly advises any other vaccinations, inoculations, or immunizations recommended bythe Center for Disease Control or federal or Maryland state health authorities. After careful

consideration of these risks, I have either received all recommended vaccinations,

inoculations, or immunizations from medical professionals or I have declined to receive

them due to my personal convictions, or medical contradictions. I agree that my decision to

decline receipt of any or all of the recommended precautionary measures increases my risk

of contracting disease and suffering other adverse consequence.

Therefore, in consideration of the privilege to participate extended to me by Generation

Revive, and on behalf of myself, administrators, I do hereby waive, release and forever

Generation Revive, its partners, staff, directors, members, agents, representatives, officers,

and volunteers from any and all actions, omissions, cause of action claims and/or damagesarising from, relating to, or resulting from my participation in the mission trip. Including but

not limited to, injury, expense, cost, damage, loss, illness, or death. I acknowledge that I

have received good and valuable consideration for signing this waiver and release. I

expressly agree that this release and waiver is intended to be as broad and inclusive as

permitted by the laws of the state of Maryland and that I intend this waiver to be binding on

my family, estate, heirs, successors, assigns, insurers, medical providers and personal

representatives. If any of this waiver and release is held invalid, it is agreed that the

balance shall continue in legal force and effect.

I have read, understood, and executed this waiver and release on _____________, 20___.

_________________________ _________________

Signature Date

_____________________________

Print Name


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FOR TEAM MEMBERS UNDER THE AGE OF 21

I, _______________________________________, am the parent/legal guardian of

__________________________ (Team Member), and

I approve and authorize Team Members participation in the Outreach Trip. I hereby agree to the terms set forth in

the waiver and release above on behalf of Team Member.

_________________________ _________________

Signature Date

_____________________________

Print Name

Individuals NameTeam Member

Name Mother or Guardian

Name Father or Guardian

Team LeaderAgent

Short-term mission

location:

Consent to travel outside the United States to _________________ (Country)The above-named Parents or Guardians of the Team Member has entrusted the Team Member into the care

of the Agent, an adult, and/or a duly authorized representative of the Organization Generation Revive, whilethe Team Member participates in a Mission trip to _______________ (Country).

The Parent or Guardian does hereby authorize the Team Member to travel outside the United States to the

nation of _________________. (Country)

__________________________ ____________________________

Signature of Mother or Guardian Signature of Father or Guardian


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BASIC EXPECTATIONS FOR PARTICIPANTS:

You are willing to be uncomfortable. You agree that this trip is not about you or your

purpose but Gods purpose. You are willing to step out in faith and be challenged like never

before in your life, willing to be used as an instrument in fulfilling the will of the father for

the nations of the earth.

We believe God calls us to be laid down lovers, completely surrendered, completely in love

and completely sold out.

AGREEMENT

Generation Revive expects compliance with rules and regulations, including the rules

concerning conduct. We are to live a life that imitates that of Christ.

Failure by team members, leaders and staff to comply with these policies is grounds for

dismissal. Team members, leaders, and staff serve at their own risk, and Generation Revive

is not liable in the event of sickness, accident, death, or terrorist acts or for transportation

and any other expense beyond normal involvement.

Application fees and all sponsor funds received by Generation Revive are contributions and

are not refundable. To receive a tax deduction, the IRS stipulates that the donor must

release control of all funds donated to a non-profit organization. For this reason,

contributions from sponsors cannot be refunded, nor can they be designated to any specific

person. The individual will be a fundraiser and will receive credit for raising funds equal to

the price of his/her trip.

I have read and understand the above information. The information I have given Generation

Revive is accurate and true to the best of my knowledge. My signature signifies my approval

of all limitations listed above.

__________________________ ______________________

Signature of Applicant: Date


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generation revive short-term missions application

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