Operation Recovery - Eastern Tennessee

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Operation Recovery - Team Leader/Individual Sign Up Application

The details of your application are kept in the strictest of confidence. Please ensure you include as many details as possible when answering each question in the application.

* A response is required in every field. If a question does not apply to you, please answer with "N/A" *

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Full Name* This field is required.

First Name

Last Name

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Email Address* This field is required.

example@example.com

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Phone Number* This field is required.

Please enter a valid phone number.

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Date of Birth* This field is required.

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Home Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Emergency Contact Name* This field is required.

First Name

Last Name

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Emergency Contact Phone Number* This field is required.

Please enter a valid phone number.

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Desired Date of Arrival* This field is required.

Date

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Desired Date of Departure* This field is required.

Date

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Are you with a Group? (Please specify your group's name)* This field is required.Are you coming with a church, organization or will your team be identified in any particular way? If you are coming alone please indicate as much by simply saying, Individual

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Are you the group leader?

YESNO

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Number of People in Your Group* This field is required.

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Do you have any known allergies?* This field is required.We do our best to accommodate during your time with us and want to ensure the safety of all participants.

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I acknowledge that I have health insurance and will bring that information with me.* This field is required.If you do not have personal health insurance or your team/family does not have it, you cannot participate.

I acknowledge, and I have health insurance

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Code of Conduct* This field is required.In order to make each mission trip a positive learning and worship experience, CrossRoads Missions asks that each participant agrees to abide by the following guidelines: -Each participant will remain in a minimum group of four, and must ask a staff person before leaving areas defined by CrossRoads Missions Staff. -The drinking of alcohol, the use of tobacco, and the use of illegal substances will not be tolerated at any time during the trip. -To avoid distraction from service and worship of God, we ask that you dress modestly and appropriately. Clothing Expectations: Shorts must have at least a 5-inch inseam. Our preference is they are not shorter than four inches above the knee. Tank tops must have a 2-inch strap. Spaghetti straps, low-cut, crop top and cut-off t-shirts or tight-fitting clothing are not permitted. If the participant’s definition of appropriate or modest differs from that of CrossRoads Missions, the participant will be asked to change. -Females will not enter the males' sleeping quarters, and males will not enter into the females' sleeping quarters unless given specific permission by CrossRoads Staff. -Power tools and vehicles will be used with permission from CrossRoads Staff and group leaders. -No sandals on the worksite. Tennis shoes or boots are fine. -We discourage the use of cell phones while on the field. Please try to limit phone usage to emergencies only. - Be considerate of the people to/with whom we are ministering and always ask permission before taking a picture.

I have read and agree with the above statement

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Final Agreement / Signatures* This field is required.By signing this form, I do hereby grant and convey to CrossRoads Missions, its partners and affiliates, all right, title, and interest in any and all photographic images, video and audio made by CrossRoads Missions during for participation in activities identified by or related to this form. This includes, but is not limited to royalties, proceeds or other benefits derived from such. Furthermore, I, for myself and the named participant on this form, and on behalf of my estate, heirs, executors and administrators do hereby fully release and discharge CrossRoads Missions, including their partners and affiliates, from any and all liabilities, claims, obligations, damages and causes of action whatsoever arising or growing out of my travel and/or participation in the programs of CrossRoads Missions. I also understand that I am responsible for all medical bills related to such activity. Should it be necessary for me to return home due to medical reasons or disciplinary action, I will assume total responsibility for all transportation costs to and from the event. I understand, that as a CrossRoads Missions participant, that I am serving at my own risk and that CrossRoads Missions is not liable in the event of sickness, injury, accident, theft, terrorist acts, or death. I, hereby consent and authorize CrossRoads Missions, its partners, affiliates, agents, and designees, to authorize any medical treatment deemed necessary while participating in any activity applicable to this form should the named participant be mentally and/or physically incapable of making such a decision. My signature likewise indicates that the information that I have provided on this application is true and accurate and that I have read this entire document, understand it completely and agree to the conditions and terms stated herein."_

I have read and agree with the above statement