Summer Missions 2019 Application

At Crossway, we are committed to be active participants in God’s Kingdom work around the world. As participants, our hope is that you grow closer to God and gain His heart for a dying world. As you fill out this application, we encourage you to continually seek God's will for you concerning these trips and what he is calling you to do.

Summer Missions Program 2019 :: Please check the trip(s) you wish to join Japan :: July 11-21 (dates subject to change) :: $2300 Mississippi :: July 20- 27 (dates subject to change) :: $1300

APPLICATION DUE BY Sunday, April 28, 2018

Complete the application online and pay the deposit ($100 - Mississippi or $200 - Japan) via credit card.

Section 1: Personal Information

Name exactly as on Drivers License or Passport

Middle Name if on Passport or DL

Name(s) of other family members going exactly on Passport or DL:

Address

Home Phone

Cell Phone

This address will receive a confirmation email

Birth date:

Passport # (for Japan trip only)

Passport expiration date:

Passport citizenship

Marital Status

Single Married Engaged Other

Do you have any medical conditions or take any medications?

Section 2: Church Background

Have you have been on a previous missions trip with Crossway? (If your answer is yes, please skip the rest of section 2)

Yes No

Give your testimony as to how and when you became a Christian.

How would you describe your relationship with Jesus Christ today?

How long have you attended the Crossway Community Church?

Are you a member of Crossway? If so, how long?

Carefully read what Crossway Church believes at http://crossway-church.com/about/what-we-believe/

Do you agree with our beliefs without reservation? Yes No

Any questions or comments about Crossway Church's beliefs?

What are some of your gifts and skills?

List and describe areas of involvement in our church and activity. Include dates of service.

Section 3: References (non-Crossway members only)

You must have one personal reference turned in to complete the application process for those that are not a member of Crossway Community Church.

Who will you request a reference from?

Reference relationship to you?

Reference phone:

Reference email:

Section 4: Acknowledgements

I acknowledge that participation in the event(s), activity(s) described herein also constitutes approval to be photographed and to have those photographs placed in Church related publications, including the church website. I recognize that there are risks involved in participating in the mission trip and hereby assume all risk of injury, harm, damage, or death in connection with my participation in it. I understand and agree that neither Crossway Community Church, nor its trustees, officers, directors, employees, agents or representatives may be held liable in any way for any injury, harm, damage, or death that may occur to me as a result of my participation in this mission trip and hereby release Crossway Community Church, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death, which may occur while I am participating in the mission trip. I authorize Crossway Community Church through its trustees, officers, directors, employees, agents or representatives to render or obtain such emergency medical care or treatment for me as may be necessary should any injury, harm or accident occur to me while participating in the mission trip. I understand and acknowledge that Crossway Community Church does not provide health or medical insurance in connection with the mission trip and I agree that I will be financially responsible for any bills incurred as a result of medical treatment, including emergency medical treatment and/or transportation to a medical facility, in connection with my participation in the mission trip.

Yes No

The information supplied in this application is accurate and truthful to the best of my knowledge.

Yes No

Minors must have a parent or guardian agree to your participation in this short term mission. By typing in your name, you declare that you are the legal parent/guardian of the listed minor(s) above, and that you consent to their full participation on this trip.

Parent/Guardian Signature:

Deposit

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Summer Missions 2019 Application

Description

Please Fix the Following