short term missions application

8/14/2019 Short Term Missions Application

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SUMMIT CHRISTIAN CHURCHS

SHORT-TERM MISSIONS APPLICATION

Summit Christian Church7075 Pyramid Highway

Sparks, NV 89436(775) 424-5683

[email protected]


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Summit Christian Church Missions

7075 Pyramid Highway, Sparks, Nevada 89436

775.424.5683

e-mail: [email protected]

Thank you for your interest in a short term missions trip. This packet contains your application,dates of the pre-trip classes, and some information that will be helpful to you now. As the pre-tripclasses begin, we will help you with your support letters, and other information that will be helpfulin your preparations.

At this time, the cost of the trips are approximate. There are factors that have to be consideredsuch as the number of team members, the skills of the team, and the supplies we will need to bringthe work. But to give you a ball park figure, the trips will be approximately $3,000 U.S. per

person.

After you completely fill out the application, please turn it in to the church office. It will bereviewed, and you will get a call from a missions team member for an interview. By submittingan application, there is no guarantee that you will be selected for the trip. If you are not selected,then the $100 deposit will be returned to you.

Applicants must be 18 years of age, or if accompanied by a parent, must have completed a year of high schools. All applicants must be in good health, must have accepted Jesus Christ as their Lordand Savior, and attend Summit Christian Church. Consideration will be made for those who attendother churches, depending on the application process and at the Missions teams discretion.

You will notice the attached calendar with dates of the pre-trip classes. You will be required toattend all classes, so please take a look to see what your commitment is to the trip and to the team.

If you have questions, please use the missions e-mail address: [email protected]

We are praying that God chooses each one for the teams, and are in much prayer through thisselection process. We encourage you to gather a prayer team just for yourself, as you go throughthe steps of the application, prepare for the trip, and especially as you are overseas.

God bless you,

Summit Missions Team


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Consider the Cost of Short-Term Missions


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Fund-raising is an integral part of your short-term mission experience. Dont let money keep you fromapplying for a short-term trip God could be waiting for an opportunity to show you how big He is!Detailed fund-raising guidelines and materials will be provided at trip meetings.Here are some inevitable costs that are your personal responsibility and separate from the cost of themission trip.

DEPOSIT & BALANCE The $100 deposit that is submitted with your application is your responsibility. In addition, if your fund-raising efforts are not entirely successful, the balance of the trip cost is also yours to pay.

PASSPORT Required for all trips out of the continental U. S. Apply now for your passport! To obtain a passport, you will need a certified birth certificate (not the hospital record), two passport

photos and a drivers license. In addition, you will need to pick up and fill out a form from the post officeand turn in the information to a postal clerk for processing with the U. S. Passport Agency. All of this cancost $65 - $100, depending on when you apply. You should allow six to eight weeks for your passport toarrive. Also, remember that it sometimes takes state agencies several weeks to provide a certified record of

your birth if you dont currently have one. Further passport services and information is available: http://travel.state.gov/passport_services.html

IMMUNIZATIONS Summits Missions Ministry supports the immunizations that are recommended by the Center for DiseaseControl. Check the diagram to determine which vaccinations are recommended and consult your physicianor the International Travel Clinic to determine costs. Vaccinations are not included in the price of the trip. Choose any medical provider at least 46 weeks before your trip to allow time for shots to take effect. Recommended vaccinations for all trips: Hepatitis A & B, Measles/Mumps/Rubella(*if born after 1956), and Travelers Diarrhea RX Required vaccinations for all trips: Tetanus/Diptheria Look at the chart below for other recommendations for your trip. (Recommended vaccinations maychange as conditions change in various countries verify this information with your medical provider.)


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Summit Christian Churchs Short-Term Missions

POLICIES & PROCEDURES

If you are interested in participating in a short-term mission trip with Summit Christian Church please read the following:

You must submit this completed application and a $100 deposit before your applicationwill be processed and reviewed. After your interview, if you are selected for a short termmissions team, the deposit will become non-refundable. If you are not selected for theteam, the deposit will be given back to you.

You will be required to sign a team covenant and must adhere to the rules outlined in

this covenant. No one will be considered or accepted as a team member until a completed application

and deposit are received.

Your application will be reviewed by members of the Summit Missions Team and youwill be called for an interview. This may be in person, or in some cases, over the phone.

Short-term mission trips can be rewarding and life-changing; however, they can also bestressful. Please consider factors in your personal life at this time that may distract and

prohibit you from fully committing to the mission of the trip and adapting to unusualconditions.

Once accepted, team members are expected to attend all team meetings.

All trip costs are the team member's responsibility and due two weeks prior todeparture. Your team leader will suggest ways to raise financial support; however, if fullsupport is not raised, the balance is your responsibility. You may not begin to raise fundsuntil you are notified of acceptance to the team and informed of proper fund raising

procedures.

If you are unable to participate in your trip, the Missions Team must receivecancellation notice as soon as possible. You may be responsible for all trip costs. Monies

put towards mission trips are contributions, and the Internal Revenue Service prohibits therefund of contributions.


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If you have physical limitations, please apply for a trip in which you are physically ableto participate. Some trips may be prohibitive for certain physical conditions. Please makethe Missions Team and your team leader aware of these conditions.

Team members will be given information regarding passports and vaccinationrecommendations from the Department of Health and/or the missionaries on the field.Passport and vaccination costs are not included in the trip costs and are the responsibility of the team member. Team members assume the responsibility and liability for their personalhealth decisions.

Additional information regarding the price and dates for each mission trip is availablefrom the Missions Team. Team meetings are designed to inform and prepare you for themission.

I have read and understand Summit Christian Churchs Short-Term Missions Policies and procedures

Signature . Date .

Missions Team Member .

Comments _.........

.


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Team Covenant As a member of this team, I agree to:

1. Remember that I am representing Jesus Christ as well as Summit Christian Church. I will modelJesus in my behavior and attitude.2. Remember that I am a guest working at the invitation of my hosts. I will remember the missionarys

prayer, Where you lead me I will follow; what they feed me I will swallow.3. Remember that we have come to learn, as well as to teach. I'll resist the temptation to inform our hosts about how we do things. I'll be open to learning about other peoples methods and ideas.4. Respect the hosts view of Christianity recognizing that Christianity has many faces throughout theworld and that the purpose of this trip is to experience faith lived out in a new setting.5. Develop and maintain a servant attitude toward all nationals and my teammates.6. Respect my team leader(s) and his or her decisions.7. Refrain from gossip.8. Refrain from complaining. I know that travel can present numerous unexpected and undesiredcircumstances, but the rewards of conquering such circumstances are innumerable. Instead of whiningand complaining, I'll be creative and supportive.

9. Attend all team meetings before the trip as well as any follow-up meetings.10. Remember not to be exclusive in my relationships. If my boyfriend/girlfriend or spouse is on theteam, we will make every effort to interact with all the members of the team. If I am attracted to ateammate, I will not attempt to pursue a relationship until after we return home.11. Refrain from any activity that could be construed as romantic interest in a national or teammate.12. Refrain from illegal drugs and abstain from consumption of alcoholic beverages or the use of tobacco while on this trip.13. Observe and practice the Summit Christian Church Statement of Faith.14. Refrain from the teaching or practice of any belief that would not be endorsed by SummitChristian Church (infant baptism, etc.). For clarification or if unsure about this issue, please talk to theSummit Missions Team leader(s) or pastoral staff.

15. I agree to abide by the fund-raising procedures endorsed by Summit Christian Church and will personally thank all financial donors that contribute to my trip.16. Remember that I can be sent home if I do not adhere to this Covenant or if my Team Leader

believes it is in my best interest or that of the team.

Signature: _______________________________________________

Date: ___________________________

Please sign to show your commitment to this covenant and keep this for your personal reference.


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OFFICE USE O NLY :Date App & Dep Recd:_________________ Sent to TL____________________________ Reply from Team Leader:________________ Trip:_________________________________ Communication w/ Team Leader __________

ENCLOSE deposit of $100. TRIP:(non-transferable and non-refundable) 1st choice ____________________________

2nd choice ___________________________

The information on this form will be kept confidential and is for use by the Summit Christian Church Missions Ministry only.

Personal Data (Please print or type)Legal name: __________________________________________________________________________ (Last) (First) (Middle) (As it appears on your passport.)

Nickname: ___________________________________________________________________________ Address: _____________________________________________________________________________ (Street) (City) (State) (ZIP)Email Address: ________________________________________________________________________ Home Phone: ( )____________ Work Phone: ( ) ______________ Place of Birth: ______________________ Date of Birth: ___________________Age: ___________

__ Male __ Female Marital status: __ S __ M __ D __ WDo you have a criminal record? __ Yes __ No If yes, please explain:_________________________ T-shirt size __ Small __ Medium __ Large __ X-Large __ XX-LargeAges of children (if applicable):

_____________________________________________________________ If under 18 years of age Name(s) of parent(s) or guardian(s):

______________________________________ Home Phone: ( )___________________ Work Phone: ( ) ___________________

Summit Christian Church InvolvementDo you attend Summit Worship services? __Yes __ No How long? _______ Are you a member of Summit? __ Yes __ No How long? _______ If not a member, where is your membership? ________________________________ Have you served in a ministry at Summit? __ Yes __ NoWhich ministries? ___________________________________Howlong?_____________________________________ Do you attend an Adult Bible Fellowship class at Summit? _ _ Yes __ NoIf so, which class?

____________________________________________________________________________ What ministries/organizations outside of Summit are you involved in? ____________________________________________________________________________ ____________________________________________________________________________ How did you hear about this mission trip? _____ Summit_____Friend _____ Website _____ Bulletin

_____ ABF Class _____ Information Center _____ Other Explain:_________________________________________________________ Return pages 4-10 to Missions & Outreach Ministry


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OccupationPlease describe your present employment and any pertinent information regarding work experience relatedto missions.

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Language Fluency(Other than English Conversation: Fluent, Fair, Poor)Language Number of Years Conversational Fluency

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Skills & TalentsPlease write the appropriate CODE next to your skills/talents.

CODES: A= Average G = Better than average P = ProfessionalI. CONSTRUCTION V. MEDICAL ______ A. Carpentry ______ A. Nursing ______ B. Painting ______ B. Physician ______ C. Masonry/Carpentry ______ C. Dental ______ D. Roofing ______ D. E.M.T. ______ E. Electrical ______ E. C.P.R. ______ F. Plumbing ______ F. Therapy (P.T.; O.T.; other) ______ G. Other ____________ ______ G. Other ________________

II. BUSINESS VI. MUSIC ______ A. Computers ______ A. Instrument (please list)_____________ ______ B. Accounting ______ B. Vocal ____________ ______ C. Other ____________ ______ C. Other ____________

III. SPORTS VII. OTHER PERFORMANCE ______ A. Basketball ______ A. Juggling ______ B. Baseball ______ B. Clowning ______ C. Soccer ______ C. Puppetry ______ D. Softball ______ D. Other ____________ What position do you play? _____________________ Coaching experience? __________________________

IV. MINISTRY EXPERIENCE ______ A. Teaching Ages:_____ ______ B. V.B.S. ______ C. Crafts(not all of these areas may be offered on all trips)


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Personality Profile1. Have you completed a Spiritual Gifts Class? If so, what are your top three gifts?

__________________________ __________________________ __________________________ 2. Describe how OTHERS view your personality:

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3. Describe your personal STRENGTHS:

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. Describe your personal WEAKNESSES:

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. Are you comfortable sharing your faith with others? _____ Yes _____ No6. How would you describe yourself: ___ introvert ___ extrovert ___ intuitive

___ fact oriented ___ feeling thinking

___ perceptive ___ decisive

Mission ExperienceOutline the mission trips you have taken, if applicable. Include how long you were on each trip, whereyou went, and what impact each trip had on your life.Trip Name: __________________________________________________________________________ Trip Dates/Year: ______________________________________________________________________ Lessons Learned: ______________________________________________________________________

_________________________________________________________________________________ _________________________________________________________________________________

_________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________

Trip Name: __________________________________________________________________________ Trip Dates/Year: ______________________________________________________________________ Lessons Learned: ______________________________________________________________________

_________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________


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My Personal Relationship with Jesus Christ & Mission Goals1. When did you become a Christian?

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 2. Describe your personal relationship with Jesus Christ.

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________ 3. Why would you like to participate in this trip?

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. What would make this mission trip a success for you?

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. Have you spoken to your family (parents/ spouse/ children) regarding this trip?

____ Yes ____ No6. How was their response to your decision to go on this trip?

____ enthusiastic ____ skeptical ____ negative ____ supportive7. Do you have any questions or concerns regarding this short-term mission trip?

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________


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Character References Name:________________________________________________________________________ Address:_______________________________________________________________________ Phone: ________________________________ Relationship: ____________________________

Name:________________________________________________________________________ Address:_______________________________________________________________________ Phone: ________________________________ Relationship: ____________________________

Name:________________________________________________________________________ Address:_______________________________________________________________________ Phone: ________________________________ Relationship: ____________________________

Please include friends, co-workers, etc. No relatives please.I understand and agree to the following policies:

I have included my $100 deposit that is due with this application and I understandthat the deposit and all contributions are not refundable. I have read and accept the Policies and Procedures and Consider the Cost of

Short-term Missions. If I cancel, I will responsible for full payment of any costs incurred my behalf in

preparation for the trip. I have read and signed the Team Covenant. I will adhere to the Team Covenant if

accepted to the Short-Term Mission Team. I commit to attending and participating in the mandatory meeting(s) for the trip(s)

that Ive applied for.

____________________________________________ _________________ Signature Date


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Short-Term Missions Medical Information & ReleaseThis form must be filled out in order for you to participate in a Short-Term Mission Trip with SummitChristian Church.

Name: ________________________________________________________ Birth Date: _______________________ Address: __________________________________________________________________________

City: _____________________________________ State: ____________ ZIP:__________________ Home Phone: ( ) ______________________ Work Phone: ( ) ______________________ Medical Insurance Provider:

___________________________________________________________ ID # _______________________________ Group # __________________________________ Will your medical insurance cover you out of the country? _____ Yes _____ NoName of Primary Physician:

___________________________________________________________ Address:

___________________________________________________________________________ City: ________________________________ State: ____________ ZIP: __________________

Phone: ( ) ____________________________ Emergency Local Contact: ___________________ Relationship: _______________________ Address: __________________________________________________________________________ City: ________________________________ State: ____________ ZIP: __________________ Home Phone: ( ) ______________________ Work Phone: ( ) _____________________ Please check if you suffer from any of the following medical conditions

__ Hypertension __ Hypoglycemia __ Bleeding Disorders __ Heart Disease __ Seizures __ Insect Allergies __ Asthma __ Chronic Anxiety __ Arthritis __ Diabetes __ Depression __ Glaucoma __ MigrainesPhysical limitations Please list :

______________________________________________________________________________

List any medications (prescription or OTC) taken on a regular basis: ______________________________________________________________________________ ______________________________________________________________________________ List Medical & Food Allergies:

______________________________________________________________________________ ______________________________________________________________________________ Blood Type: ___________ Have you had any surgery in the past three years: __ Yes __NoIf so, please explain:

_________________________________________________________________ In an emergency, I give my permission to a licensed physician to hospitalize or anesthetize me, or perform surgery on me. Iunderstand that every effort will be made to inform my emergency contact before these actions are taken.Signature: ____________________________________________________Date: ______________________

Parent/Guardian Signature: ______________________________________ Date: ______________________ (only if participant is under 18 years of age)Relationship to Participant:____________________________________

Summit Christian Church


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Statement of Faith

Summit Christian Church is an independent, nondenominational fellowship. Since our founding in1999, we consistently have tried to be a church where Christians from diverse backgrounds canworship freely together. We have laid aside the differences of our background to unite through the

love of Jesus Christ, and to serve together to help build His kingdom. With this in mind, we haveestablished the following abbreviated statements which summarizes our beliefs. The leadership and pastors at Summit are united in their agreement upon these points. This is what we believe, and this iswhat we teach:

God: God is the one and only Sovereign Creator. God is a spiritual being. He is holy (without sin),all knowing, all powerful, everywhere present, and eternally existent. (Exodus 3:14-15; Timothy 6:15-16; Isaiah 40:13-14; John 4:24; Psalm 90:1-6) God the Father, God the Son, and God the Holy Spiritare distinct personalities with distinct roles, but one God. (Matthew 28:19; John 1:1-2, 10:30, 14:7-10,25-26; Colossians 1:15-19; Hebrews 1:1-4)

Jesus Christ: Jesus became God in the flesh. He existed in the beginning with God, and was God.He then was born a man through the miracle of the virgin birth by the power of the Holy Spirit.Despite temptation, He lived a sinless life. (Matthew 1:18-25; Luke 1:26-45; John1:1-2, 14; Hebrews4:14-15)

Jesus was crucified and died a physical death as an atonement for the sins of mankind. He experienceda physical resurrection from the grave. (Luke 23:23-23, 53; I Corinthians 15:3-8; I John 2:2)

Jesus came in the flesh as our Savior; He will return in the future in bodily form as the victorious Lordof the Universe. At the time, He will gather together His followers and will pass judgment upon thosewho have rejected Him. (Mark 13:32-37; Acts 1:9-11; Titus 2:13; Hebrews 9:27-28)

The Holy Spirit: The Holy Spirit lives within those who believe in Jesus Christ. He is our Comforter,our Advocate, and He helps us to become more like Jesus in thought, word, deed, and character.(Galatians 2:20-21; John 14:15-17, 16:5-15)

Mankind, Sin, and Salvation: Men and women were created in the image of God, but are nowseparated from God by sin. (Isaiah 64:6-7; Romans 3:23, 5:12-21, 6:23; I John 1:8)

Faith (belief, trust) in Jesus based on His sacrifice on the cross is the only way for men and womento be reconciled to God (John14:6; Acts 4:8-12; Romans 3:25-26)

Salvation, offered through Jesus is based upon grace, not merit. Salvation therefore cannot be earned;it is a gift from God. What we could not do for ourselves (reconcile our relationship with God), Jesusdid this for us through His death on the cross. (Ephesians 2:8-9)

God lovingly offers salvation to every person; every person has the freedom to accept or reject this giftfrom God at any time. (John 3:16-18; I Timothy 2:3-4; II Peter 3:9)


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Faith (belief, trust in Jesus requires repentance (conforming our lifestyles to that of Christ. Faith inJesus results in obedience. Baptism by immersion demonstrates our response to Gods offer of salvation as a pledge of willingness to live for Him. (Acts 3:19; 2:38, 8:26-38; Romans 6:1-4; I Peter 3:21)

The Bible: We believe the Bible is inspired by God and is therefore without error or contradiction,and is the sole authority for faith and practice. All our beliefs come from the Bible. (II Timothy 3:15-

16; II Peter 3:15-16; John 17:17)

The Church: The Church of Jesus Christ is no limited to anyone institution or denomination; itconsists of all who have placed their trust in Jesus Christ to provide redemption for their sins. Summittherefore is but one part of the total Church (I Corinthians 12:12-17; Ephesians 4:4-6)

I have read the Statement of Faith and agree with its doctrine. I have accepted Christ as my Lord andSavior.

Signature .

Date .

Adult Release and Indemnification Agreement


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In consideration of the undersigneds application for participation in a mission trip sponsored by SummitChristian Church of Sparks, Nevada, Inc. (the Church) and as an inducement to organizing the mission tripand permitting the undersigneds participation agrees as follows:The undersigned hereby fully and forever releases and waives and agrees not to cause to be brought any and allclaims, demands, actions, or causes of action of every possible kind and nature whatsoever the undersignedmight assert, including, without limitation, claims for personal injury, wrongful death, or property damage,whether or not absolute, now or unknown, or otherwise against the Church or any of its trustees, elders, officers,employees, agents and volunteers (collectively referred to herein as the Releasees) by reason of, arising out of

or relating to the undersigneds participation in a church mission trip. The undersigned further agrees toindemnify, defend and hold the Releasees harmless from damages, including, without limitation, special,incidental and consequential damages, losses or expenses suffered or paid, directly or indirectly, as a result of any and all claims, causes of actions, suits, proceedings, demands, judgments, assessments, and liabilities,including reasonable attorneys fees incurred in litigation or otherwise, assessed, incurred or sustained by or against the Releasees by reason of, arising out of or relating to the undersigneds participation in a Churchmission trip. The undersigned further agrees that this Release and Indemnification Agreement (theAgreement) is binding upon the undersignedsheirs, executors, administrators, assigns and legal representatives; that this Agreement releases all successors,assigns and legal representatives of the Releasees; and that this Agreement is to be governed by the law of theState of Nevada.

The undersigned further agrees that the execution of this Agreement is continuing in nature; it is theundersigneds knowing and voluntary act; the undersigned does not intend to participate in the mission trip untiland unless the undersigned has had full opportunity to the undersigneds satisfactions to inspect and determinethe scope of the mission trip and receive all information from the leader or Church Mission Ministry which bear on the undersigneds decision to participate; and the undersigned is under no duress or undue influence toexecute this Agreement.

The undersigned hereby grants full permission to the Church to use any photographs, videotapes, motion pictures, recordings, or other records or documents of the mission trip and to do so without notice or compensation to the undersigned. The undersigned acknowledges that the Church has made availableapplications for travel insurance and agrees that it is the undersigneds responsibility to purchase travelinsurance. The undersigned assumes responsibility for full payment of the published and announced cost of the

mission trip; agrees to pay any outstanding balance upon request by the Church; and agreesthat any and all cost incurred by the undersigned during the mission trip, including, without limitation, costs dueto health problems, emergencies and death, are the responsibility of the undersigned or estate of theundersigned.

The undersigned certifies that the information provided in the undersigneds application for participation in theChurch mission trip is true, complete and correct and acknowledges that the undersigned has read andunderstands this Agreement; that the undersigned has not relied in signing this agreement on any statement, oralor otherwise, by the Church; and that it is the undersigneds intention with this Agreement to make a complete,general and unconditional release of any and all claims whatsoever against the Releasees as set forth above.

IN WITNESS WHEREOF, the undersigned hereby executes this Agreement on the date set forth below.

Date: _______________________ Signature: ________________________________________________ Printed Name: _____________________________________________


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Youth Release and Indemnification AgreementThe undersigned enters into this Agreement as the parent or legal guardian of the below-named minor:

__________________________________________.

In consideration of the undersigneds application for participation in a mission trip sponsored by SummitChristian Church of Sparks, Nevada, Inc. (the Church) and as an inducement to organizing the mission tripand permitting the undersigneds participation agrees as follows:

The undersigned hereby fully and forever releases and waives and agrees not to cause to be brought any and allclaims, demands, actions, or causes of action of every possible kind and nature whatsoever the undersignedmight assert, including, without limitation, claims for personal injury, wrongful death, or property damage,whether or not absolute, now or unknown, or otherwise against the Church or any of its trustees, elders, officers,employees, agents and volunteers (collectively referred to herein as the Releasees) by reason of, arising out of or relating to the undersigneds participation in a church mission trip. The undersigned further agrees toindemnify, defend and hold the Releasees harmless from damages, including, without limitation, special,incidental and consequential damages, losses or expenses suffered or paid, directly or indirectly, as a result of any and all claims, causes of actions, suits, proceedings, demands, judgments, assessments, and liabilities,including reasonable attorneys fees incurred in litigation or otherwise, assessed, incurred or sustained by or against the Releasees by reason of, arising out of or relating to the undersigneds participation in a Churchmission trip. The undersigned further agrees that this Release and Indemnification Agreement (theAgreement) is binding upon the undersigneds heirs, executors, administrators, assigns and legalrepresentatives; that this Agreement releases all successors, assigns and legal representatives of the Releasees;and that this Agreement is to be governed by the law of the State of Nevada.

The undersigned further agrees that the execution of this Agreement is continuing in nature; it is theundersigneds knowing and voluntary act; the undersigned does not intend to participate in the mission trip untiland unless the undersigned has had full opportunity to the undersigneds satisfactions to inspect and determinethe scope of the mission trip and receive all information from the leader or Church Mission Ministry which bear on the undersigneds decision to participate; and the undersigned is under no duress or undue influence toexecute this Agreement.

The undersigned hereby grants full permission to the Church to use any photographs, videotapes, motion pictures, recordings, or other records or documents of the mission trip and to do so without notice or compensation to the undersigned. The undersigned acknowledges that the Church has made availableapplications for travel insurance and agrees that it is the undersigneds responsibility to purchase travelinsurance. The undersigned assumes responsibility for full payment of the published and announced cost of themission trip; agrees to pay any outstanding balance upon request by the Church; and agrees that any and all costincurred by the undersigned during the mission trip, including, without limitation, coasts due tohealth problems, emergencies and death, are the responsibility of the undersigned or estate of the undersigned.

The undersigned certifies that the information provided in the undersigneds application for participation in theChurch mission trip is true, complete and correct and acknowledges that the undersigned has read andunderstands this Agreement; that the undersigned has not relied in signing this agreement on any statement, oralor otherwise, by the Church; and that it is the undersigneds intention with this Agreement to make a complete,general and unconditional release of any and all claims whatsoever against the Releasees as set forth above.

IN WITNESS WHEREOF, the undersigned hereby executes this Agreement on the date set forth below.Date: _______________________ Parent or Legal Guardian: ____________________________________ Signature: ________________________________________________ Printed Name: _____________________________________________


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Short Term Missions

Application Check List

Name

Trip Location .

Phone Number (H) . (C) .

1. . Applications complete2. . Policies and Procedures explained and signed3. . Team Covenant signed4. . Medical Release completed5. . Statement of Faith signed6. . Adult/Youth Release signed7. . Team Covenant signed8. . Interview date with9. . Deposit paid date check cash

short term missions application

Documents