Short Term Mission Trip Application

1 Start 2 Complete
Contact Information
Type NA if you don't have a passport yet.
Personal Information
Past Mission Trips
Education and Experience
Family and Health Information
Answers to these questions will help us determine how to best support you on this mission trip.
Please note, any medication you list will be kept confidential and is solely for the use of planning of this trip. If you aren't currently on medication please answer "n/a".
If no special diet is required please answer "n/a".
Personal Beliefs
Acknowledgement and Agreement
Affirmation of Accuracy: I affirm that all of the information contained in this application is true and correct to the best of my knowledge. I understand that I may be asked to speak confidentially with a staff member regarding any of my answers, and agree to do so. Commitments: If selected to be a part of this mission trip, I commit to participating (attending) all team meetings. I commit to being a part of the planning process prior to departure. I commit to participating in a post-trip debriefing session. I commit to conduct myself in a manner worthy of the Lord while serving Him on this trip and on this team. I commit to submit to the authority of the team leader(s) and the host on-the-field and to outlined team policies. I commit to refraining from any behavior which may compromise my witness (i.e., abusive language, drug use, etc.) Additionally, if at any time while on the trip my behavior constitutes a problem, the team leader has the authority to ask me to return home. Any additional expenses incurred as a result of this action will be at my cost. Release of Liability: In consideration of receipt and evaluation of this application by First MB Church, I hereby release First MB and its representatives, as well as any outside individual, group, agency, or organization, from any and all liability for damages of whatever kind or nature, including claims for breach of privacy, that may at any time result to me, or anyone entitled to recover through me or because of their relationship to me, in connection with the preceding Authorization. Further, in consideration of First MB allowing me to participate in a Short Term Mission Trip, I, for myself as well as for anyone entitled to recover through me or because of their relationship to me, hereby waive and release all right and claim for damage that may exist against First MB and its agents, employees, representatives, volunteers, successors and assigns (collectively, "the Released Parties"), for any and all injuries or damages of any sort suffered by me arising out of my participation. I further agree that in the event any party or entity makes any claim against the Released Parties for injuries or damages arising out of such participation, I will indemnify, defend, and hold the Released Parties harmless, from any and all damages occasioned thereby, including attorney's fee.
Please type your full name.