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Misssion trip application.

ACKNOWLEDGEMENTS & RELEASE FORM

 

 

1. I UNDERSTAND THAT I AM SIGNING

UP FOR A MISSION TRIP

I acknowledge that I am volunteering my time and efforts in service for Christ through the ministries of New Beginnings Church, and that I will receive no monetary compensation or insurance benefits for my time or services performed.

 

 

2. WHAT I CREATE AT CHURCH

BELONGS TO THE CHURCH

It is acknowledged that in my capacity as a volunteer for New Beginnings Church, I have in the past, at present, and in the future will create, author, make and design various creative works of every kind and nature, recorded on and in tangible, electronic, audio, video and any and all other mediums and technologies now existing and yet undeveloped. I agree that the creative works created as a volunteer are for the exclusive ownership of New Beginnings Church and that each of the creative works is created as a “work made for hire” as defined by the United States Copyright Act and

at all stages of development each of the creative works shall be and remain the sole and exclusive property of New Beginnings Church.

At New Beginnings Church’s sole, absolute, and unfettered discretion, New Beginnings Church may make any changes in, deletions from, or additions to the creative works. If for any reason, the results and products of my volunteer services for New Beginnings Church are determined at any time not to be a work made for hire, I agree to assign and do hereby irrevocably assign to New Beginnings Church all right, title and interest to the creative works, including but not limited to all trademark, copyright, patent and trade

secret rights.

 

 

3. I AM VOLUNTEERING

AT MY OWN RISK

I acknowledge and accept the risk of physical injury that could occur from my participation aon a mission trip. Except for gross negligence on the part of New Beginnings Church, I accept personal financial responsibility for any bodily or personal injury sustained while I am on the mission trip. Further, I release and agree to indemnify and hold harmless New Beginnings Church, and its officers, directors, and representatives from any liability, injury, damage, loss, accidents, delay or irregularity related to being a volunteer for New Beginnings Church.

 

 

4. YOU CAN TAKE MY PICTURE

I grant to New Beginnings Church the right to make photo, video, and audio recordings of me as well as the perpetual, world-wide right to record, re-record, copy, edit, reproduce, publicly display, perform and distribute the recordings in any way consistent with New Beginnings Church’s ministry, including use on the Internet. I waive the right to inspect or approve the finished product wherein the recording appears.

 

 

5. I WON’T SHARE CONFIDENTIAL

INFORMATION

New Beginnings Church wishes to maintain in confidence all information including marketing information, data, technology, commercial and research strategies, trade secrets, inventions and know-how disclosed by New Beginnings Church to me, directly or indirectly, in written, oral or other tangible forms. New Beginnings Church also wishes to keep all contact information private and prohibits it to be used for personal reasons. In this regard, I agree that I will not disclose the confidential information and/or trade secrets with others without prior written consent of New Beginnings Church, both during or after my volunteer service.

I Agree

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Do you have a passport?*
No
Yes

If so, when does it expire?
Have you ever been on a mission trip?*
No
Yes
Have you ever been on a trip with NB Church?*
No
Yes
What year did you receive Christ your savior?*
No
Yes
Do you currently attend NB church?*
No
Yes

If yes, how long have you been attending our church? *
Shirt Size:*
Small
Medium
Large
Xtra Large
XX Large
XXX Large
Do you have, or have had any diseases or health problems?*
No
Yes

If so please explain.

Emergency Contact: *

Emergency Contact Number:
Are you able to make payment by the due date?*
Yes
No
Possibly

Any Comments/Questions you may have, please put them here.
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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