CA Mission Team Member Information

CA Mission Team Member Information

All information will be kept confidential.
Name

First NameLast Name
Which trip are you participating in?
Country/Countries of Citizenship
Emergency Contacts

Please provide two contacts in case of an emergency. These contacts should not be on the trip with you.
Name

First NameLast Name
Relationship
Phone number
Email
example@example.com
Name

First NameLast Name
Relationship
Phone number
Email
example@example.com
Parent / Legal Guardian Identification

If you are under 19 years of age, please upload a clear photo or scanned copy of both parents’ or legal guardians’ passports. If they do not have a passport, a government-issued photo ID (e.g., driver’s license) may be submitted instead.

Please upload one form of ID for each parent/legal guardian.
Browse Files

Cancelof
Medical Information
Personal Health Number
Which province issued your health card?
Name of doctor
Doctor's phone number
Do you have any allergies, dietary restrictions, chronic illnesses or conditions?
Please describe.
Do you take prescription medication?
Please list the name and function of each medication.
This information will be kept confidential and only used to ensure your safety and wellbeing. *Please bring your own allergy medication and enough prescription drugs for the duration of the trip. It is best to keep medication in original packaging with labels.
Financial Policy
I understand that all funds raised are non-refundable, even if I cannot attend the mission trip
I understand that if I don't adhere to the Team Commitment, I will be required to return home at my own expense
Signature
Should be Empty:

CA Mission Team Member Information

Emergency Contacts

Parent / Legal Guardian Identification

Medical Information

Financial Policy