Next Gen | NYSUM 2026 | Adult Pastor/Leader

Adult Leader Participation Form – NYSUM 2026 Youth Mission Trip
This form is to be completed by all Youth Pastors and Adult Leaders participating in the Youth Mission Trip to New York City at NYSUM ( March 29–April 1, 2026).

The information you provide will be used to complete the required background check for all adults attending the trip.

You will also be asked to provide your pastor’s email address so we can request a pastoral reference.

Please fill out each section thoroughly to help us ensure a safe and healthy environment for every student on this trip.
Legal Name*

Legal First NameLegal Last Name
US Social Security Number*
Date of Birth*

MonthDayYear
Date
Age*
Place of Birth
Email*
example@example.com
Confirm Email*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone Number*

Area CodePhone Number
Gender*

MaleFemale
Have you ever been convicted of a crime by a judge or court of law?*

YesNo
If Yes, Please Explain
Have you ever been convicted of or arrested for a sexual crime?*

YesNo
If yes, please explain
This form is secure through Jotform.com
Ministry Experience
What is your position in the church?*

Lead PastorAssociate PastorYouth PastorChildren's PastorYouth LeaderRegular AttendeeParentOther
List any Christian ministry in which you are CURRENTLY engaged. Include dates, places, & responsibilities:*
List any Christian ministry in which you engaged in the PAST. Include dates, places, & responsibilities:*
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Church email*
Church phone
Expectations of Your Pastors and Leaders
Conduct & Responsibility
Adult leaders on this trip are expected to model responsibility in every aspect of their participation. This includes being punctual, prepared, attentive, and fully present for all scheduled activities. Leaders must follow all instructions from NYSUM staff and the Elim Fellowship team, maintain appropriate boundaries with students, and uphold all safety guidelines. Because students watch and imitate the behavior of those leading them, we ask every adult to carry themselves with integrity, maturity, and a commitment to doing what is right—even when no one is watching.

Spiritual Maturity
Leaders are expected to demonstrate a consistent and growing walk with Christ. This includes a lifestyle that reflects biblical values, a heart of humility, and a desire to serve others. Leaders should be examples of Christlike love, compassion, patience, and grace, both toward students and toward other team members. Because this trip is a spiritual experience for our youth, we rely on our leaders to encourage, support, and guide them in ways that point them to Jesus. We ask that each leader come ready to pray, encourage, and spiritually invest in the youth entrusted to their care.

Emotional Maturity
Adult leaders must be able to handle stress, unexpected changes, and the challenges of group dynamics with stability and grace. Youth ministry can be unpredictable, and leaders must respond to conflict, correction, or pressure in a calm and appropriate manner. Emotional maturity also means being teachable, receiving direction without defensiveness, and working cooperatively with the entire leadership team. Leaders should demonstrate patience with students, respect for peers, and the ability to maintain a positive and steady presence throughout the trip.
I have read the above statement and will endeavor to "guard the unity of the Spirit in the bond of peace."*

Yes
LINK:

https://elimfellowship.org/event/youth-mission-trip-to-nyc
I have read through the webpage listed above in its entirety and understand and agree with everything stated therein.*

Yes
Pastoral Reference
Pastor's Name*

First NameLast Name
Pastor's Title*
Title or Job Description
Pastor's Email*
Please double check that your Pastor's Email is accurate to keep from delays.

Your Pastor will automatically be sent an email requesting they fill out this form:

https://form.jotform.com/253505894748168

Pleas feel free to send them this link yourself to ensure they notice it and it doesn't get sent to a Junk folder/
Verification
AUTHORIZATION: I authorize Elim Fellowship to contact any person listed on this form. I also authorize all listed persons and employers to release any such information and release them from any and all liability for providing that information.
Authorization:*

YesNo
WAIVER: I hereby authorize Elim Fellowship to make any investigation of my personal history, credit record and criminal record through any investigative or credit agencies or bureaus of their choice.
Waiver Authorization:*

YesNo
ELECTRONIC SIGNATURE*

Check this box to authorize your signature
Please Print Name Here*
Date*

MonthDayYear
Any other Information we may need:
Once you have completed this form, please click the “Submit” button below.
Should be Empty:

Adult Leader Participation Form – NYSUM 2026 Youth Mission Trip

Expectations of Your Pastors and Leaders

Pastoral Reference

Verification