MISSIONS APPLICATION | Memorial Baptist Church

MISSIONS TRIP APPLICATION

This from is required to be submitted by all persons who plan to attend a Memorial Baptist Church Short-term Mission Trip (minors included). Thank you for your interest in a Memorial Baptist Church short-term mission trip! In this packet you will find: • Policies and Procedures • Team Member Application • Financial Policy and Procedures • Medical Information Form • Emergency Release Form • Release of Liability Form • Release of Liability for Minors Form • Background Check Consent Form Please provide your signature in the areas noted. Once completed, please submit your completed and signed form and application along with the required $100 trip deposit (unless otherwise noted) payable to Memorial Baptist Church. Any previously completed applications per individual are considered valid for up to 2 years. Deposits can be turned in to Memorial Baptist Church office or mailed to: Memorial Baptist Church 109 W Church St Williamston, NC 27892 If you have any questions about this document or short-term mission trip ministry at Memorial Baptist Church, please send inquiries to: ministries@membap.org. Policies and Procedures If you are interested in participating in a short-term mission trip with Memorial Baptist Church, please read the following: 1) Each applicant applying for a short-term mission trip must fill out an application and complete each individual section. This includes spouses and children (must be a high school freshman or older unless otherwise indicated.) 2) Send questions to ministries@membap.org. 3) Acceptance to go on a trip is not guaranteed. Acceptance to a trip is dependent on multiple factors including trip capacity, skill sets, ministry gifts, experience, etc. Priority will be given to Memorial Baptist Church members. As part of the application process, trip leaders may choose to hold informational interviews with the candidates applying. Should you not be selected for a trip, your $100 deposit will be refunded; this is the only reason a refund would be provided. 4) A background check will be performed on applicants 18 and older applying to a mission trip. 5) Upon approval of the application, the trip leader will provide further information about the next preparation steps. NOTE: DO NOT solicit any funds for support and/or make any commitments on behalf of Memorial Baptist Church without prior approval. 6) Applicants must be at least a high school freshman unless otherwise noted for a specific trip. All applicants under 18 must receive parental approval. 7) Team members are expected to attend all mandatory team training meetings. 8) Short-term mission trips can be rewarding and life-changing; however, they can also be stressful. Please consider factors in your personal life at this time that may distract and prohibit you from fully committing to the mission of the trip and adapting to unusual conditions. 9) If you have physical limitations, please apply for a trip you are physically able to participate in. Some trips may be prohibitive for certain physical conditions. Please discuss with the team leader if you have concerns. 10) Team members assume responsibility for their personal belongings on the trip. Memorial Baptist Church will not reimburse team members for items that are lost, stolen, or confiscated during the trip. 11) Upon being approved by them leadership to join a missions team, you will be expected to share your passport information with team leadership should the trip require a passport.

I have read and understand the paragraph above in its entirety and agree to its conditions without any exceptions. *

I have and understand

Application Date *

Name *

First

Middle

Last

Preferred Name

Gender *

Male
Female

Date of Birth *

Country of Citizenship *

Physical Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Relationship to Memorial Baptist Church *

Member
Regular Attender/ Active Participant
Occasional or Non-Involved Member
Involved in another church

If you marked "Involved in Another Church" please give the name and location of the church.

Are you serving in a ministry of MBC? *

If you marked "Yes" please indicate where you serve at MBC.

Please list any MBC ministries or church ministries you have been involved with in the past and present. Please provide dates and ministry leaders as needed. *

List any Memorial Baptist Church pastors, staff members, members, or ministry leaders who could serve as references: *

Personal Background - Describe how you came to trust Jesus Christ as your Savior. *

Share the Gospel message in your own words and understanding. *

Ministry Experience and Spiritual Gifts - List any cross-cultural and short-term mission experience whether domestic or international. *

To the best of your knowledge, what gifts, talents, abilities, and professional skills do you have that might contribute to your ministry on a short-term mission trip? *

If you have taken spiritual gifts assessment, what are your top three spiritual gifts? *

If you have not taken a recent assessment, please ask for a spiritual gifts assessment to be sent to you in the space above.

Do you speak a language other than English? If so, please list along with fluency (i.e. a little, conversational, fluent):

Briefly explain what you hope to see the Lord do in and through you on this mission trip. *

What do you do when you have a conflict with someone? How do you handle confrontation?

What are the realistic roadblocks that might keep you from going on a mission trip? (Either generally and/or specifically for this trip.) *

A mission trip requires a major time commitment. In addition to the trip itself, the team will meet multiple times for training in the eight weeks leading up to the trip dates. *Are you willing to commit to the necessary time requirements for this trip? *

Are you willing to raise support for you and your team for this trip? *

In submitting this application: 1) I have read and agree to the trip policies and procedures. 2) I whole-heartedly submit to the team leadership and will follow their direction and instructions. 3) I will, Lord willing, and to the best of my ability, attend all training sessions and complete all training requirements. 4) I am confirming that I have the time and energy to devote to the pre, mid, and post-trip responsibilities. 5) I am willing to work under the direction of missionaries and national pastors to accept and to perform all assignments cheerfully and with a God-honoring attitude. 6) I will be flexible in my deportment, adjusting my demeanor, posture, and manner as needed. 7) I will agree to return home at my own expense if the team leader determines that my behavior is/has been inappropriate. 8) I will diligently walk with the Lord in His Word and through consistency in prayer in an intentional effort to spiritually prepare to minister and serve as a participant of a short-term mission trip. *

Clear Signature

Signature Required (Legal Guardian when applicable)

Financial Policies and Procedures Payment Options • To comply with the IRS, all checks should be made payable to Memorial Baptist Church • All checks must include the participant’s name and trip location in the memo line • Online Giving will be available for each trip at membap.org/missions Trip Costs Each team budget will contain several major expense categories. Examples may include airfare; vehicle rental; housing costs; food and drink; ministry materials; gifts for hosts; and more. Every effort is made to minimize costs without jeopardizing the quality, effectiveness, or safety of the ministry. Separate Itineraries Separate itineraries arranged by the individual short-term participants are not allowed. Travel arrangements go much smoother if everyone has the same itinerary. Separate itineraries make it more complicated for planning and make it more difficult to arrange for group discounts. Separate itineraries also disrupt team bonding and unity. Exceptions may be made if a team member is staying for extended ministry reasons. Deposit Information • A $100 deposit is required with this application • Make check payable to Memorial Baptist Church • The $100 deposit will go towards the total cost of your trip (unless otherwise noted) Team Member Contribution Each short-term team participant should contribute at least 10% out of his/her own personal finances toward the cost of the trip. This includes the $100 deposit (submitted at the time of application submission). Participants are encouraged not to contribute more than 50% of the cost of their trip, even if they have the finances to afford it. Payment Schedule: • 90 days prior to mission trip: $100 trip deposit and application paperwork due • 30 days prior to mission trip: 50% of the balance due • 14 days prior to mission trip: Full payment due. *

Clear Signature

Signature Required (Legal guardian when applicable)

Financial Policies and Procedures (continued) Financial Memo of Understanding 1) I understand that I am responsible for raising 100% of the funds required for my trip, beyond what Memorial Baptist Church has already covered. The money I raise covers travel, food, lodging, exit taxes, ground transportation, and other expenses associated with the trip. 2) I am responsible for passport fees, souvenirs, immunizations, prayer letters, personal meals separate from the team, and some tourist-type events. Memorial Baptist Church will not be responsible for extra trip expenses unless otherwise indicated (i.e. airline changes). 3) Financial donations made to Memorial Baptist Church for this mission trip are not mine; they belong to God and have been given to Memorial Baptist Church to accomplish the mission and work of the church. 4) If I do not ultimately participate on the mission trip to which I have been accepted, I am responsible for and will reimburse Memorial Baptist Church for any fees incurred as a result of my cancellation. (i.e. purchased airline tickets) 5) If I do not participate on the mission trip to which I have been accepted, I understand that the monies donated to my trip cannot be refunded to me or the donors due to the non-profit status of Memorial Baptist Church. All materials, including airline and other travel tickets, that have been purchased with donated funds cannot be transferred. 6) I understand if I do not meet the funding deadlines, I may not be allowed to go on the Missions trip. Any money raised will not be refunded, but will be applied to the current trip or other mission ministries. 7) If I raise an amount of money that exceeds my needs, the remaining money will be dispersed to other team members in need or used by Memorial Baptist Church for other financial needs associated with this mission trip or future ministry trips. 8) I agree to return home at my own expense if the team leadership determines that my behavior is/has been inappropriate. Money raised will not be refunded. I have read and agree to the above policies, rules, and terms. *

Clear Signature

Signature Required (Legal Guardian when applicable)

Insurance Company

Policy Holder Name *

First

Middle

Last

Policy Holder Relation to Attendee

if applicable

Policy Number *

Group Number *

Insurance Address *

Address Line 1

Address Line 2

City

State

Zip Code

Insurance Phone *

Physician Name *

First

Last

Physician Address *

Address Line 1

Address Line 2

City

State

Zip Code

Physician Phone *

Primary Emergency Contact Name (please provide two) *

First

Last

Relationship *

Primary Contact Phone *

Primary Contact Address *

Address Line 1

Address Line 2

City

State

Zip Code

2nd Emergency Contact Name *

First

Last

Relationship *

Secondary Contact Phone *

Secondary Contact Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date of Last Tetanus Shot *

List any allergies (foods, medications, bees, pollen, etc.) and reactions to these allergies: *

List any special dietary needs and/or requirements: *

Please list any medications you are currently taking: *

Do you have any health problems that might hinder you during this mission trip? (e,g, back or chest pain, daily mandatory medical needs, physical or mental disability, etc.) *

If you checked Yes, give a brief description.

Memorial Baptist Church Short Term Mission Teams and their appointed team leaders have my permission to authorize any medical treatment deemed necessary for me or my child by the aforementioned and the attending physician, including administration of medication, anesthesia, emergency surgery, or hospitalization. I agree to assume complete financial responsibility for all medical bills incurred by me or my child. I agree to assume total financial responsibility to travel home immediately if it is necessary for medical or any other emergency reasons. *

Clear Signature

Signature Required (Legal Guardian when applicable)

In signing this form, I, the undersigned person, agree not to hold Memorial Baptist Church, its officers, employees, or other agents liable for any injury, loss, damage, or accident that I might sustain while on a mission event/effort. I realize and acknowledge that my participation on a mission trip to a foreign country includes risk and possible dangers. I understand my travel to such a foreign country exposes me to such risks as accidents, disease, war, political unrest, injury from construction projects, and other calamities. I hereby assume any such risks that might result from my participation in any such missions project, and I unconditionally agree to hold Memorial Baptist Church, its officers, employees, or other agents harmless for any liability concerning my personal health and wellbeing, or any liability for my personal property that might be lost, damaged, or stolen while on a mission trip. I hereby expressly forever release and discharge Memorial Baptist Church, its officers, employees, or agents from all such claims, demands, injuries, damages, or causes of action arising from any conduct on the part of Memorial Baptist Church, its officers, agents, or employees.

Clear Signature

Signature Required (Legal Guardian when applicable)

In signing this form, I, the undersigned parent and/or legal guardian of the participant listed in this application, agree not to hold Memorial Baptist Church, its officers, employees, or other agents liable for injury, loss, damage, or accident arising out of the church's negligence or that negligence of its officers, employees or other agents that I (and my minor children) participating might sustain while on one of its mission trips to _____________________, from __________ (date) to __________ (date). I realize and acknowledge that my (and my minor child's/children's) participation on a mission trip to a foreign country includes many risks and possible dangers. I understand my travel to a foreign country exposes me to such risks as accidents, disease, war, political unrest, injury from construction projects, and other calamities. I hereby assume risks that might result from my travel to a foreign country, and I agree to hold Memorial Baptist Church, its officers, employees, or other agents harmless for liability concerning my personal health and well-being arising out of Memorial Baptist Church's negligence, and liability for my personal property that might be lost, damaged, or stolen while on a mission trip arising out of Memorial Baptist Church's negligence. I also give permission for my child to travel with an assigned staff member from Memorial Baptist Church outside the United States of America and give that person permission to administer medical care in the case of an emergency. I have carefully read the foregoing and I understand that my signature herein holds Memorial Baptist Church, its officers, employees, or other agents harmless for liability for injury, damage, loss, accident, delay, or irregularity in schedule arising out of the church's negligence or the negligence of its officers, employees, or other agents. *

Clear Signature

Legal Guardian Signature Required when applicable

I, the undersigned applicant of this form, hereby authorize Memorial Baptist Church to conduct a background check by any entity chosen by Memorial Baptist Church specifically for conducting this search to release information regarding any record of charges or convictions in any criminal file maintained on me, whether the said file is a local, state, or national file, and including but not limited to accusations and convictions for crimes committed against minors, to the fullest extent permitted by state and federal law. I do release Memorial Baptist Church and other entities from all liability that may result from any such disclosure made in response to this request.

Clear Signature

Signature Required (Not required if under 18 years old)