Mission Trip Application
We invite you to participate in our next mission trip. We will use interpreters to share testimonies and teach the people. We will also bring games and prizes for the children and distribute food and clothing. This mission is a significant opportunity to impact people's lives positively. The cost is $1500 per person. If you have any questions, please get in touch with Don Calvin at dwcalvin@gmail.com.
Application Date
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Trip Location
The trip you are applying for
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Honduras (June 9th-14th)
Mexico (August 11th-16th)
Trip Date
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Name
First Name
Middle Name
Last Name
Gender
Male
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Birth Date
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Age
Country of Citizenship
Street Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
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Passport Information
Country
Passport Number
Issue Date
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Year
Date
Place of Issue
Expiration Date
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Personal Background
Check one and complete the requested information
Member
Regular attender and active in church
Occasional or non-involved attender
Involved in a church other than Real Life Church
If you selected (Partner) above, please provide the date you became a member of Real Life Church.
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Month
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Day
Year
Date
If you selected (Regular Attender), please provide the date you started attending Real Life Church.
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Month
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Day
Year
Date
If you selected (Involved in a church other than Real Life Church), please specify the church you currently attend.
Are you currently attending a small group?
Yes
No
If yes, what is your leader's name?
List any Real Life Church ministries you have been involved with, past and present. Please provide dates and ministry leader.
Please list one pastoral reference and two personal references (include names with email or phone numbers).
Describe how you came to trust Jesus Christ as your Savior.
Describe your current devotional practice (Bible study & prayer).
How have you grown spiritually in the past year?
Are you involved in any ministries outside of Real Life Church? Please describe.
Describe how you would explain the gospel to a non-believer.
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Ministry Experience & Spiritual Gifts
List any cross-cultural and short-term experiences.
What gifts, talents, abilities, and professional skills do you have that might contribute to your ministry in the short-term mission trip?
If you have taken a spiritual gifts assessment, what are your top spiritual gifts?
Do you speak a language other than English? If so, please list it along with your fluency (i.e., a little conversational, fluent.)
Briefly explain what you hope to see the Lord do in and through you on this mission trip.
How do you think your involvement will strengthen the team?
What do you do when you have a conflict with someone? How do you handle confrontation?
What are the realistic roadblocks that might keep you from going on a mission trip?
A mission trip requires a major time commitment. In addition to the trip itself, the team meets for training. This training could be up to two hours per week for at least 8 weeks before the trip.
Are you willing to commit to the necessary time requirements for this trip?
Yes
No
What possible time conflicts might you have during preparation and debriefing periods?
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Financial Information
Payment Options
To comply with the IRS, all checks should be payable to Real Life Church. The memo line must include the participant’s name and trip location.
Trip Costs
Each team budget will contain several significant expense categories. Examples may include airfare, vehicle rental, housing costs, food and drink, ministry materials, gifts for hosts, and much more. Every effort is made to minimize expenses without jeopardizing the ministry's quality, effectiveness, or safety. We will work with travel agents who specialize in working with short-term mission groups. These travel agents can find discounted rates for ministry work and can provide help in working with foreign governments, international banking, passports, and visas. The travel agents also offer invaluable assistance in dealing with emergency changes in travel itineraries approved by the short-term trip leader.
Separate Itineraries
Separate itineraries arranged by the individual short-term participants are not allowed. Travel arrangements can go much smoother if everyone has the same itinerary. Separate itineraries make planning more complicated and challenging, as well as arranging for group discounts. Separate itineraries also disrupt team bonding and unity. Exceptions may be made if a team member stays for extended ministry reasons.
Deposit Information
A $100 non-refundable deposit is required with this application. Make check payable to Real Life Church.The $100 deposit will go toward the total cost of your trip
Team Member Contribution
Each short-term team participant should contribute at least 10% of their finances toward the cost of the trip. This includes the $100 deposit (submitted at the time of application time).
Financial Memo of Understanding
I understand that I am responsible for raising 100% of the funds required for the trip. The money I raise covers travel costs, food, lodging, exit taxes, ground transportation, and other ministry expenses associated with the trip. I am responsible for passport fees, souvenirs, immunizations, prayer letters, personal meals separate from the team, and some tourist-type events. The travel agency or Real Life Church will not be responsible for extra trip expenses (i.e., airline changes) Financial donations made to Real Life Church for this mission trip are not mine— they belong to God and have been given to Real Life Church to accomplish the mission and work of the church. If, for some reason, I do not ultimately participate in the mission trip to which I have been accepted, I am responsible for and will reimburse Real Life Church for any fees incurred due to my cancellation (i.e.purchased airline tickets). If, for some reason, I do not participate in the mission trip to which I have been accepted, I understand that the monies donated to my trip cannot be refunded to me or the donors due to the non-profit status of Real Life Church. All materials, including airline and other travel tickets purchased with donated funds, cannot be transferred outside the trip. If I do not meet the funding deadlines, I may not be allowed to go on the mission trip. Any money raised will not be refunded but will be applied to the current trip or other mission ministries. Suppose I raise an amount of money that exceeds my needs. In that case, the remaining money will be dispersed to other team members in need or used by Real Life Church for other financial needs associated with this mission or future ministry trips. I will agree to return home at my own expense if the team leadership determines that my behavior is /has. It has been inappropriate, and none of the money raised will be refunded to me or any donors. I have read and agree to the above policies, rules, and terms.
Participant's Name
First Name
Last Name
Signature
Legal Guardian if Under 18 (Must be accompanied by a legal parent/guardian)
First Name
Last Name
Signature
Date
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Month
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Day
Year
Date
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In Submitting this Application
I agree with the Real Life Church Covenant and Team Covenant. I have read and agreed to the trip policies and procedures. I wholeheartedly submit to the team leadership and will follow their directions and instructions. I will, Lord willing, attend all training sessions and complete all training requirements. I have the time and energy to devote to the pre-, mid-, and post-trip responsibilities. I am willing to work under the direction of missionaries and national pastors to accept and perform any assignments cheerfully and with a God-honoring attitude. I will be flexible in my deportment, adjusting my demeanor, posture, and manner. I will agree to return home at my own expense if the team leader determines that my behavior is/has been inappropriate.
I acknowledge that any minor (under the age of 18) participating in this trip must be accompanied by their legal parent or guardian. The parent or guardian assumes full responsibility for their child throughout the duration of the trip. No minor will be chaperoned by any team member other than their parent or guardian.
Participant's Name
First Name
Last Name
Signature
Date
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Month
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Day
Year
Date
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Medical Information
Name
First Name
Last Name
Insurance Information
Insurance Company
Policy Holder
Relationship
Policy Number
Group Number
Insurance Co Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Physician Information
Primary Care Physician
Physician Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
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Emergency Contact Information
Please provide the contact information of two individuals not traveling with your team who may be contacted in the event of an emergency.
Name
First Name
Last Name
Relationship
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Alternate Contact
Name
First Name
Last Name
Relationship
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Is your tetanus shot current?
Yes
No
Date of last tetanus shot
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Month
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Day
Year
Date
List any allergies (foods, medications, bees, pollen, etc.) and reactions to these allergies.
List any special dietary needs/requirements.
Please list any medications you are currently taking.
Do you have any health problems that might hinder you during this mission trip (back or chest pain, daily mandatory medical needs, physical or mental disability, etc.)?
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Emergency Medical Release Form
Real Life Church Short-Term Mission Teams and their appointed team leaders have my permission to authorize any medical treatment deemed necessary for me or my child by those above and the attending physician, including medication administration, anesthesia, emergency surgery, or hospitalization. I agree to assume complete financial responsibility for all medical bills incurred by me or my child. I agree to assume total financial responsibility to travel home immediately if necessary for medical or any other emergency reasons.
Name
First Name
Last Name
Signature
Parent's Signature (if under 18 years of age)
Date
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Date
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Short-Term Release of Liability
In signing this form, I, ____________________, agree not to hold Real Life Church, its officers, employees, or other agents liable for any injury, loss, damage, or accident I might sustain while on a short-term mission event/effort. I realize and acknowledge that my participation in a mission trip to a foreign country includes risks and possible dangers. I am well aware that my travel to such a foreign country exposes me to such risks as accidents, disease, war, political unrest, injury from construction projects, and other calamities. Right now, I assume any risks that might result from participating in any such mission project. I unconditionally agree to hold Real Life Church, its officers, employees, or other agents harmless for any liability concerning my health and well-being or for my personal property that might be lost, damaged, or stolen while on a short-term mission trip. I, at this moment, expressly forever release and discharge Real Life Church, its officers, employees, or agents from all such claims, demands, injuries, damages, or causes of action arising from any conduct on the part of Real Life Church, its officers, agents, or employees.
Signature
Parent's Signature (if under 18 years of age)
Date
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Month
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Day
Year
Date
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Authorization & Request for Criminal Records Check
I, _________________________________, at this moment authorize Real Life Church to conduct a ground screen by any entity chosen by the Church precisely for conducting this search to release information regarding any record of charges or convictions in any criminal maintained on me, whether the said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed against minors, to the fullest extent permitted by state and federal law. I release Real Life Church and other entities. I'd like to point out that all liability may result from any such disclosure in response to this request.
Signature of Applicant
Date
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Date
Print all other names the applicant uses (if any, including maiden name).
Birth Date
Please select a month
January
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Please select a year
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Social Security Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Please return this form to Don Calvin by emailing it to dwcalvin@gmail.com
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