ZAMBIA 2026 MISSION TRIP APPLICATION FORM

ZAMBIA 2026 MISSION TRIP APPLICATION FORM
Personal & Contact Information
Full Name (as it appears on your passport):*

First NameMiddle NameLast Name
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If outside Canada or the US, please manually provide full home address below:
Date of Birth:*

MonthDayYear
Date
Email:*
example@example.com
Phone Number:*
Please enter a valid phone number.
Gender:*

MaleFemale
Marital Status:*

SingleEngagedMarriedWidowedDivorcedSeparated

Passport Information

If you don’t have a passport yet, send this application anyway. You should apply for a passport now and send a copy of the information page as soon as you receive it.
Your full name (as it is/will be in your passport):*

First NameMiddle NameLast Name
Passport Number:*
Nationality:*
Place of Birth (City & Country):*
Issue Date:*
Place of Issue:*
Expiry Date (Must be valid 6 months past July 2026):*

MonthDayYear
Date

Ministry & Spiritual Journey
How long have you been a follower of Christ?*
Home Church Name:*
Pastor's Name*
Briefly describe your testimony. Please include, 1. When and how did you come to know Jesus Christ as your personal Saviour? 2. Describe how you have grown in your walk with the Lord since your conversion.: *
What are your primary spiritual gifts? (e.g., Evangelism, Children's Ministry, Intercession, Administration, Worship)*
Have you been on a mission trip before? If so, where?*
Skills or Experience Relevant to the Mission Trip (Helps with task assignment)*
Why do you feel it is God's will for you to join this mission trip specifically?*
Are you comfortable praying for people publicly and sharing the Gospel one-on-one? (Yes / No / I’d like training in this)*

Medical & Emergency

Who we contact in case of emergency while you are overseas. If you are under 19 years old this must be your parent(s) or guardian.
OHIP # (for citizens of Ontario, Canada):
Emergency Contact Name:*

First NameLast Name
Relationship to you:*
Emergency Contact Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Phone Number:*
Please enter a valid phone number.
Emergency Contact Email:*
example@example.com
Do you have any severe allergies (food or environmental)? If so, please list:*
Are you managed on any medications we should be aware of? If so, please list:*
Do you have any disabilities that we should be aware of? If so, please share:*
Do you have anything else in your medical history that we should know about? If so, please share:
Health Confirmation:*

I acknowledge that I am responsible for obtaining the doctor recommended vaccines (Hepatitis A/B, Typhoid, etc.) prior to departure.

Pastoral or Spiritual Mentor Reference

Please provide at least one reference from your pastor or church elder (not a relative).
Reference 1 Full Name:*

First NameLast Name
Reference 1 Email:*
example@example.com
Reference 1 Phone Number:*
Please enter a valid phone number.
Reference 2 Full Name:

First NameLast Name
Reference 2 Email:
example@example.com
Phone Number
Please enter a valid phone number.

Zambia 2026 Mission Team Covenant

Our goal is to be of 'one mind and one accord' (Philippians 2:2)
As a member of the Reviving Africa mission team, I understand that I am an ambassador of Jesus Christ and a representative of this ministry. I commit to the following:

1. A Spirit of Submission & Unity
I agree to submit to the leadership of Reviving Africa and the local Zambian pastors we partner with. I will prioritize the unity of the team, refraining from gossip or complaining, and will address any conflicts directly and biblically with the parties involved.

2. Cultural Sensitivity & Respect
I understand that I am a guest in Zambia. I commit to honouring local customs, traditions, and dress codes (modesty), even if they differ from my own. I will maintain a humble, "servant’s heart" toward the local community at all times.

3. Flexibility & Endurance
I acknowledge that mission work can be "jam-packed," unpredictable, and physically demanding. I commit to maintaining a positive attitude through schedule changes, long days, and the "stretching" of my comfort zone, trusting that God is at work in the chaos.

4. Spiritual Preparation & Participation
I commit to being spiritually prepared through regular prayer and Word study before we depart. I will faithfully attend the monthly team meetings and the weekly intensive preparations starting four weeks prior to the trip, recognizing these are vital for the team's success.

5. Purity & Conduct
I commit to a lifestyle that reflects the Gospel. While on this mission, I will refrain from any behaviour (verbal, physical, or social) that could hinder the ministry’s reputation or cause a fellow believer to stumble.
Confirmation:

I have read the Team Covenant and agree to abide by these standards for the duration of the Zambia 2026 Mission Trip.

Consent & Signature
I, First Name*Last Name* , hereby agree to participate in the Zambia 2026 Mission Trip from June 24 to July 9, 2026, organized by Reviving Africa, and I hereby acknowledge that there are certain risks and dangers associated with this activity. I acknowledge that these risks include, but are not limited to, injury, illness, and death, as well as loss or damage to personal property.

In consideration of being permitted to participate in this activity, I agree to assume full responsibility for any risks, injuries, or damages that I may sustain, or that my property may sustain, as a result of my participation in this activity. I agree to release, waive, discharge, and hold harmless Reviving Africa and Reviving Africa Zambia, its officers, directors, employees, and agents, from any and all claims, damages, or liabilities that may arise out of or in connection with my participation in this activity.

I further agree to indemnify and hold harmless Reviving Africa and Reviving Africa Zambia, its officers, directors, employees, and agents, from any and all claims, damages, or liabilities that may arise out of or in connection with my participation in this activity, including but not limited to, claims made by third parties.

In the event of an emergency, I hereby authorize Reviving Africa and its representatives to consent to any medical treatment, including surgery or blood transfusions, which they deem necessary for my health and well-being. I agree to be financially responsible for all costs associated with such medical care and any necessary emergency medical evacuation

I agree that this agreement shall be governed by and construed in accordance with the laws of Ontario, Canada, and any legal proceedings related to this waiver shall take place in the courts of that jurisdiction.

I understand that this Liability Waiver and Release Agreement is a binding legal agreement, and I sign it voluntarily and with full knowledge of its contents. I acknowledge that I have read and fully understand the terms and conditions set forth in this agreement.
Date*

MonthDayYear
Date
Signature*

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QUESTIONS? Call Kiko: +1-647-702-0850 or email info@revivingafrica.org

Reviving Africa and Reviving Africa Zambia will not sell or forward your personal information to any other organization. RA uses information for internal personnel and administrative procedures.
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ZAMBIA 2026 MISSION TRIP APPLICATION FORM

Personal & Contact Information

Passport Information

Ministry & Spiritual Journey

Logistics & Commitment

Medical & Emergency

Pastoral or Spiritual Mentor Reference

Zambia 2026 Mission Team Covenant

Consent & Signature