Mission Trip Registration

Mission Trip Registration
Trip*
Personal Information
Full Legal Name*
As shown in the passport
Birth Date*

MonthDayYear
Passport Number
Passport Expiration Date

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Marital Status*

MarriedSingle
T-Shirt Size
Occupation / Employer
Church Name and Location
Pastor's Name
Pastor's Phone
Please enter a valid phone number.
Pastor's Email
example@example.com
Are you involved in serving in church ?
Are you leading or being part of the ministry?
Are you involved in a Bible Study group?

YesNo
Are you baptized?

YesNo
Describe any major life changes that you have undergone in the last 5 years?
Special Skills
Languages you speak

Health Information
Do you have any physical/mental handicaps or allergies that we need to be aware of for your participation on this mission trip?

YesNo
Explain
Please list all current medications
Please list any allergies
Physician's Name
Physician's Phone
Please enter a valid phone number.
Emergency Contact
Emergency Contact Relationship
Emergency Contact Phone Number
Please enter a valid phone number.

Additional Information
Personal Testimony
References

One from a Pastor or church leader, one from a family member and one from a friend
Cancelof
How did you hear about us?
Personal Commitment
I understand that participating in a mission trip is a way of demonstrating my faith.

I understand that group participation, and unity among the team are essential to the success of the mission of this team and I take full responsibility for being a part of team meetings, planning, prayer, and devotions.

I also understand that I am representing the Lord with my words and actions and that I am under authority of In Missio Dei leadership and the local church/ministries leaders.
Signature*

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Date*

MonthDayYear
Date
Policies and Terms of Agreement
- Trip payments are considered a tithe donation and are nonrefundable, no exception.
- You must have a valid passport at time of registration
- There will be a minimum of 3 in-person Team Trainings that are MANDATORY to attend.
- Online registrations are not final until confirmed by a follow up phone call/meeting
- If you have any questions, please feel free to contact andrea.bettio@inmissiodei.org.
- I agree with the Terms & Conditions and the Privacy Policy, and understand that my registration is pending until it is approved and based on availability.
Accept Terms and Conditions

I understand as a participant I am fully responsible for the cost of my tripI plan to raise support for all/ some of the cost of my trip
Payment

Pay In FullDeposit
Amount

prevnext( X )
USDDescription
Calculation
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Mission Trip Registration

Personal Information

Health Information

Additional Information

Personal Commitment

Policies and Terms of Agreement