Short-Term Mission Trip Application & Release Forms

SHORT-TERM MISSION TRIP APPLICATION & RELEASE FORMS

THIS IS A MICROSOFT WORD FORM-FILLABLE APPLICATION TO BE COMPLETED ON A COMPUTER. WE CANNOT ACCEPT HANDWRITTEN APPLICATIONS.

(Also available online to download as a PDF form-fillable application that can be completed on a computer)

If you are younger than 16 years old, you must have a parent

or other adult who will be responsible for you while on this mission trip.

Dates of mission trip for which you are applying:

GENERAL INFORMATION:

Full Name (EXACTLY as it appears on passport):

Name you prefer to be called:

Passport #: Date Issued: Expiration Date:

Include a copy of your passport with this application, or send it separately if you are applying for a passport.

Birth Date: (Month/day/year) Marital Status: Single Married

Permanent Mailing Address:

Phone: (Home) (Work) (Cell)

E-mail:

If you are younger than 18 years of age or still in high school, complete the following information:

Name of Parent(s)/Legal Guardian:

Mailing Address:

Phone: (Home) (Work) (Cell)

E-mail:

EMERGENCY CONTACT INFORMATION

Name: Relationship:

Phone #(s):

E-mail:

MEDICAL INFORMATION

State of your present health: Excellent Good Average Poor

List any health problems and the medications taken to treat each health problem:

List any allergies or physical difficulties that might affect your involvement:

Physician’s Name:

Address: Phone:

MINISTRY INFORMATION (If you’ve completed this SHIP form for a previous trip, you do not need to complete the Ministry Information/References sections again unless there is a change in your info.)

Church Member? Yes No If so, where?

Have you gone on previous mission trips? Yes No

If so, where?

Briefly describe your relationship with Christ as your personal Savior:

Have you had experience sharing your faith? Yes No

If so, please describe the situation:

What would you say to someone who wants to know WHY he/she should become a Christian (including Scripture references)?

Please comment on your personal time of prayer and Bible study:

Special skills or abilities:

Languages you speak fluently (other than English):

References

If you have never been on a SHIP international trip, please give two references. Include the person’s name, relationship to you, and phone number.

1. Name: Relationship: Phone #:

2. Name: Relationship: Phone #:

The training meetings for this mission trip are critical, ensuring success for your entire team. Do you commit to faithfully attend at the scheduled times? Yes No

T-shirt size for your SHIP trip shirt:

Photo/Video Release: By signing this application form, I hereby grant permission to SHIP to the rights of my image, likeness, and sound of my voice as recorded on audio or video tape without payment or any other consideration. Photographic, audio or video recordings may be used by SHIP for the following purposes: informational presentations, promotional materials, newsletters, website, and Facebook.

Notice of Understanding

· Completion of this application may not necessarily guarantee a place on the respective mission trip.

· Each application will be reviewed by SHIP’s staff.

· It is each applicant’s responsibility to secure the necessary finances for their mission trip.

· Cancellation Policy: Your deposit is non-refundable!

To the best of my ability, I have completed this application to participate in a SHIP mission trip. I have also read and agree to abide by the policies (provided in this application packet) set forth by SHIP.

______

Date Print Name of Participant Signature of Participant

If the applicant is a minor (under 18 years old) or is still in high school:

______

Date Print name of Parent/Legal Guardian Signature of Parent/Legal Guardian

Please print, sign, and return all forms, along with any required deposits, to:

SHIP
PO Box 3003
Bryan, TX 77805

Fax: 979-260-8589

AGREEMENT AND RELEASE FROM LIABILITY

Voluntary Participation

I, , acknowledge that I have voluntarily applied to participate in a mission trip to El Salvador with Shelter the Homeless International Projects (SHIP). SHIP is providing assistance in arranging the mission trip, which involves travel to and volunteer work in the United States or El Salvador.

Assumption of Risk

I am aware that the mission trip poses risks including but not limited to: sickness, crime, political instability, governmental opposition, personal injury, death, as well as similar and dissimilar risks.

I am aware that the mission trip may involve risks. I am voluntarily participating in the mission trip with the knowledge of the risks involved. I HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH THAT MAY RESULT FROM MY PARTICIPATION IN THE MISSION TRIP.

Release from Liability

As consideration for being permitted by SHIP to participate in the mission trip, as consideration for

SHIP assisting in arranging the mission trip, and for other good and valuable consideration the receipt and sufficiency of which is hereby acknowledged, I hereby irrevocably and unconditionally release, waive, discharge, and covenant not to sue or attach the property of Shelter the Homeless International Projects, or any of their affiliates, subsidiaries, divisions, members, directors, officers, employees and agents (collectively referred to as the “Releasees”), for and from all claims of any nature now or hereafter existing whether known or unknown, including but not limited to all liability, on account of death, injury, or damage resulting from the negligence or other acts, however caused, of the Releasees as a result of my participation in the mission trip. I UNDERSTAND THAT I AM GIVING UP MY LEGAL RIGHTS AND THE RIGHTS OF MY REPRESENTATIVES TO RECOVER FOR INJURY, DEATH, OR PROPERTY DAMAGE.

Knowing and Voluntary Execution

I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself on the one hand, and SHIP and/or their affiliates on the other hand. No oral representations, statements, or inducements apart from this agreement have been made to me.

I SIGN THIS AGREEMENT OF MY OWN FREE WILL.

______

Date Print Name of Participant Signature of Participant

If the applicant is a minor (under 18 years old) or is still in high school:

______

Date Print name of Parent/Legal Guardian Signature of Parent/Legal Guardian

MEDICAL RELEASE FORM

This form must be completed and signed where indicated. By signing this form, the SHIP team member (or parent/guardian) affirms having read it.

Shelter the Homeless International Projects (SHIP) purchases medical expense/emergency assistance insurance for each team member from www.MissionTripInsurance.com (TripArmor plan) to cover medical expenses and emergency transportation for a sickness or injury that occurs while on the mission trip. Insurance ID cards are emailed to each team member prior to the mission trip.

I, , hereby give permission for any and all medical attention to be administered to me under the direction of Ann or Robert Horton or Leon or Noralee Moore (mission trip team leaders) in the event of an accident, injury, sickness, etc. while I am on the mission trip to San Salvador, El Salvador, with the Shelter the Homeless International Projects (SHIP) team. I also assume responsibility for the payment of any such treatment. This release is in effect from to (dates of the mission trip).

Knowing and Voluntary Execution

I have carefully read this agreement and fully understand its contents. I am aware that this is a release for medical treatment. No oral representations, statements, or inducements apart from this agreement have been made to me.

I SIGN THIS AGREEMENT OF MY OWN FREE WILL.

If during the course of this mission trip I should become ill or sustain an injury requiring medical attention, I hereby authorize Ann or Robert Horton or Leon or Noralee Moore (mission trip team leaders) to obtain emergency medical services on my behalf. I will assume financial responsibility for the bills incurred.