Student Mission Trip Application 2022

Please make sure that you have these things filled/turned in.

*Fill out online form

*Copy of insurance card (electronically or physically turned in)

*$100 non-refundable deposit by April 24th
(You will be fully registred when application and deposit is received)

*TURN IN ALL ELECTRONIC DOCUMENTS INTO BRYCE COOPER bryce@manorwoods.com
STUDENT MISSION TRIP APPLICATION

Johnson City, TN | July 11-16
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Gender*

MaleFemale
Maritial Status*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Participant's Cell#*

Area CodePhone Number
Home #*

Area CodePhone Number
MEDICAL INFORMATION
Physician's Name*
Phone Number*

Area CodePhone Number
Health Insurance Provider*
Name of Policy Holder*
Policy Number*
Group Number*
Check all over-the-counter medications you will NOT allow to be dispensed to this participant

AsprinAcetaminophen (Tylenol)Ibuprofen (i.e. Advil, Motrin)Nasal Decongestant (i.e. Sudafed)Pepto BismoCough Suppressant (i.e. Robitussin, menthol cough drops)
Any allergic reactions to food or medicine?

YesNo
If the answer is YES please specify:
Is the participant currently under doctor supervision for any of the following:

EpilepsyDiabetesAsthma
Is the participant taking any prescription medications?

YesNo
If YES please specify:
CHURCH OF CHRIST AT MANOR WOODS INVOVLEMENT
Are you a member of CCMW?

YesNo
If not a member are you:

Regular AttendeeFormer MemberReferred to CCMW
If not a member where do you attend church?
PERSONALITY PROFILE
Describe at least 2 of your personal strengths:
Describe at least 2 of your weaknesses:
SPIRITUAL HISTORY
When & how did you become a Christian?
Describe your personal relationship with Jesus Christ?
MISSION TRIP EXPERIENCE
Why do you want to go on this trip?
What would make the mission trip a success to you?
Do you have any questions or concerns regarding this trip?
MISSION TRIP POLICIES & PROCEDURES
If you are interested in participating in a short-term mission tripo with the Church of Christ at Manor Woods, please read the following and sign in agreement of the terms:

*Participants must adhere to rule outlined in the team covenant. Please read it before applying.

*Short-term mission trips can be rewarding and life-changing; however, they can also be stressful. Please consider physical, spiritual and emotion factors in your personal life that may distract and prohibit you from fully committing to the mission of the trip and adapting to unusual conditions.

*Once accepted, team members MUST attend ALL team meetings:

May 15th Fundraiser
(TBA)

June 5th Team Member Retreat

*All trip costs are the team member's responsibility

*I will be responsible of attending all financial fundraisers that are required of me.

*Financial Agreement Dates:

Deposit: $100 due by April 24

Final Payment: $250 due by June 31
MISSION TRIP TEAM COVENANT
As a team member of this trip, I agree to:

1. Remember that I am representing Jesus Christ as well as the Church of Christ at Manor Woods. I will model Jesus in my behavior and attitude.

2. Remember that I am a guest working at invitation of my hosts. I will remember the missionary’s 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 temptation to inform our hosts about “how we do things.” I’ll be open to learning about other people’s methods and ideas.

4. Develop and maintain a servant attitude toward all nationals and my teammates.

5. Respect my team leaders(s) decisions.

6. Refrain from complaining. Travel can present numerous unexpected and desired circumstances, but the rewards of conquering such circumstances are innumerable. Instead of whining and complaining, I’ll be creative and supportive.

7. ATTEND ALL TEAM MEETINGS!

8. No illegal drugs, alcohol, or weapons (includes knives) on this trip.

9. Abide by the fund-raising procedures endorsed by Church of Christ at Manor Woods and will personally thank all financial donors that contribute to my trip.

10. 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.
PARTICIPANT SIGNATURE:

Clear
PARENT SIGNATURE IF PARTICIPANT IS UNDER THE AGE OF 18

Clear
Should be Empty:

STUDENT MISSION TRIP APPLICATION

MEDICAL INFORMATION

CHURCH OF CHRIST AT MANOR WOODS INVOVLEMENT

PERSONALITY PROFILE

SPIRITUAL HISTORY

MISSION TRIP EXPERIENCE

MISSION TRIP POLICIES & PROCEDURES

MISSION TRIP TEAM COVENANT