MISSION  APPLICATION

Participant Information

Participant's Parent/Guardian Information

Mission Related


Emergency Medical Information

Confidentiality of Medical Information
Your medical information will remain confidential. It will be reviewed only by the team leader(s), and solely for the purpose of being informed about any health concerns that may help them respond appropriately in the event of an emergency during the mission trip.
Before the trip, the team leader(s) will review your information privately. During the trip, your medical form will be stored in a sealed envelope and accessed only in case of an emergency. Once the mission trip concludes, the envelope will be destroyed securely using a paper shredder.

Insurance

Medical

Primary Care Provider

Emergency Contact

Authorization of Consent to Treatment

I, (name), hereby authorize the mission team leader(s) of West Lawn United Methodist Church to act as my agent(s) in giving consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care, as deemed necessary by a licensed physician or surgeon. This care may be provided in a physician’s office, hospital, or other medical facility.
This authorization is given in advance of any specific diagnosis or treatment and is intended to permit team leader(s) to authorize such care as, in their judgment, may be necessary during the mission trip. It is understood that this consent is given so that appropriate care can be provided promptly in case of illness or injury.
This authorization shall remain in effect for the entire duration of the mission trip, from the time of departure from West Lawn United Methodist Church until the time of return.

(if participant is under 18, parent/guardian must sign)

Food Service

While on the mission trip, all team members will be expected to help regarding meals.


Skill Level Information

All skill levels are welcome and encouraged to participate! This assessment is simply to help us understand the overall strengths of our team and determine the types of projects we can take on. Please respond honestly using the following key to rate your experience in each category.

1. No skill (no experience/skill with this type of work before and would require detailed direction)

2. Low skill (minimal experience & would require direction)

3. Moderately skilled (done this type of work multiple times & would require minimal direction)

4. Highly skilled (done this type of work many times before, requires no direction)

5. Professional (do professional construction work)

Parent/Guardian Permission

Note: All safety guidelines and supervision protocols will be followed. These tasks will only be assigned if age-appropriate and approved by the team leader.

Transportation


Please note: All drivers must hold a valid driver’s license and must provide a copy as proof prior to the mission trip. This applies to anyone driving a personal, church, or rental vehicle during this trip.

Personal Vehicle Information

If you plan to drive your personal vehicle during the mission trip, please provide the following information. Be aware that in the event of an incident, your personal auto insurance will be considered the primary coverage.
Please note: All drivers must provide a copy of their vehicle's proof of insurance prior to the mission trip.

Media Release and Consent

I, (name), hereby grant permission to West Lawn United Methodist Church and its authorized designees to photograph, video record, or otherwise capture my image and voice. I further grant West Lawn United Methodist Church the right to use, reproduce, exhibit, display, broadcast, or distribute these images and recordings—now or in the future—in any media format, for the purpose of promoting, publicizing, or explaining the church’s ministries, programs, or activities, or for any other lawful purpose it deems appropriate.
I understand that the church reserves the right to edit, crop, or treat the images at its discretion. I also acknowledge that once my image or voice is posted or published on the internet or in public media, it may be accessed, shared, or downloaded by others beyond the control of West Lawn United Methodist Church.
Therefore, I agree to release, indemnify, and hold harmless West Lawn United Methodist Church, its pastors, employees, agents, members, and designees from any and all claims, liabilities, or damages arising from the use of my image or voice.
I understand that all photographs, video recordings, and audio recordings taken are the sole property of West Lawn United Methodist Church.

(if participant is under 18, parent/guardian must sign)

Release and Indemnification of West Lawn United Methodist Church

I, (name), agree to indemnify, hold harmless, and defend West Lawn United Methodist Church, including its pastors, employees, agents, members, servants, and designees, from and against any and all claims, liabilities, damages, losses, or expenses. This includes, but is not limited to, attorney’s fees, court costs, investigative expenses, and any other costs that may arise or be alleged to have arisen from:
  • My use of any real or personal property belonging to West Lawn United Methodist Church or its representatives;
  • Any act or omission on my part while participating in activities associated with the mission trip.
This release applies to any claims of injury, damage, or loss that may occur, whether caused by negligence or otherwise, during my involvement with the mission trip or related activities.
(if participant is under 18, parent/guardian must sign)

Agreement

By submitting this application, I understand that it does not guarantee participation in the mission trip. Final team selection will be made at the discretion of the trip leader(s).
I further acknowledge that the following commitments are essential for the effectiveness, quality, and spiritual integrity of this mission experience. Therefore, as a member of this mission team, I agree to:
  • Represent Jesus Christ in my thoughts, words, actions, and overall service. I understand that I serve as a representative of Christ and will strive to reflect His love and character throughout the trip, keeping both the spiritual purpose and the task at hand in focus.
  • Remain with the team at all times, unless given permission by the team leader(s) to separate for a specific reason.
  • Maintain a servant’s heart—toward those we are serving and toward every member of our team.
  • Pray regularly for our team, the people we’ll serve, and our team leader(s), offering them respect and support in their decisions.
  • Refrain from judgment, keeping a spirit of grace and humility in all interactions.
  • Respect the religious views of others, including our hosts, those we are serving, and fellow team members—recognizing that faith may be expressed in different ways.
  • Foster unity and harmony among the team, our hosts, and those we are serving. I will be mindful and respectful of local customs, laws, and conditions. I commit to following the teachings of Jesus, especially the Golden Rule, using wisdom, patience, and cultural sensitivity in all situations.
  • Abstain from the use of alcohol, tobacco (including vaping), illegal drugs, profanity, and any behavior or clothing that may be considered inappropriate or offensive. I will refrain from negativity, gossip, and a complaining spirit.
  • Maintain a positive, flexible, cooperative attitude, especially in relation to food, lodging, transportation, and work assignments. I agree to work in unity with the team leader(s) and fellow team members.
  • Keep the main thing the main thing—to serve Jesus Christ wholeheartedly from the moment we depart until we return home.
(if participant is under 18, parent/guardian must sign)

Submit