Calvary Chapel Chattanooga Missions Ministry Team Member Application

Transcription

1 Calvary Chapel Chattanooga 2016 Missions Ministry Team Member Application

2 Application Instructions: To be considered for an upcoming short-term trip, you must: 1. Complete the following application. 2. Pay your deposit. Deposit must be paid online upon delivery of application. Visit and select your trip. Click the Deposit button, then follow the steps. Applications may be turned into the Information Booth during a weekend service. During the week, you can deliver to the Missions Department at the church offices (3535 St. Elmo Avenue). If you have any questions or need additional information regarding the application process, please contact: Zack Rannick: zack@calvarychatt.com

3 Short-Term Team Member Application Application Date: Location and date of trip: Personal Information (As appears license/passport) Name: Last First Middle Street Address: City: State: Zip Code: Home Phone: ( ) - Cell Phone: ( ) - Work Phone: ( ) - Gender: ( ) Male ( ) Female Date of Birth: (Must be 18 years of age or older to apply) Occupation: Marital Status: Single Engaged Married Widowed Separated Divorced If Married, Spouse s Name: If you have children, Children s Name(s) Age Gender Do you regularly attend a small group? ( ) Yes ( ) No Please give the name of small group leader and how long you have attended: Relationship to Calvary Chapel Chattanooga How long have you attended Calvary Chapel Chattanooga: (months/years) Please list any of the ministries in which you are currently serving at Calvary Chapel: If you are a member of a church other than Calvary Chapel Chattanooga, please specify which one:

4 References List a small group leader or another church leader (pastor, elder) of Calvary Chapel Chattanooga who knows you and could best serve as a reference. Phone Number or Sky Miles If you would like to receive Sky Miles credit for your trip, you must put your information below. We will do our best to submit your information to the selected airline. Delta: Name: SkyMiles Number: American Airlines: Name: AA Advantage Number: Passport Information *Not applicable for domestic trips Do you have a passport? ( ) Yes ( ) No ( ) Applying Name (as it appears on your passport): Passport Number/Issue Date: Nationality/Place of Issue: Passport Expiration Date: If you have your passport, you must fill out this information now. If you do not have your passport, you must apply by the trip application deadline. Upon acceptance to the team, you must submit three color copies of your passport to the Missions Department. Travel Insurance Information Calvary Chapel Chattanooga will purchase traveler s insurance on your behalf. Please list your beneficiary for this purpose below. Name Relationship

5 Other Information: Do you consider yourself (an): Introvert Extrovert Fact-Oriented Perceptive Intuitive Feeling Have you been involved with any of the following within the past year? Alcohol Tobacco Illegal Drugs Cult Criminal Activities If yes, please explain: Have you ever been convicted of a crime? yes no If yes, please explain: Do you have any conditions that might affect your ability to fully function as a team member on this trip? (ie: fear of flying, depression, etc): Please list any relevant medical certifications you currently possess: Please list any languages you speak (other than English) and your proficiency:

6 IF YOU HAVE BEEN ON A SHORT TERM TRIP WITH CALVARY CHAPEL CHATTANOOGA SINCE 2010, YOU ONLY NEED TO ANSWER THE QUESTIONS MARKED WITH AN *. Please answer the following questions on another sheet of paper (please type or print legibly). Personal Background Please share your story of salvation in Jesus Christ with 100 words or less. Describe two or three defining moments in your spiritual journey and explain their significance. Describe your current devotional practices (Bible Study and prayer) to grow in your relationship with Christ. *What do you believe is the biblical purpose/goal of global missions? *How are you practically living out the biblical mandate to make disciples in this context? Tell us more about your talents, work experiences, skills, and/or foreign languages that may be helpful for future trips (sports, drama, music, VBS, construction, teaching, medical training, etc). How would you best describe your spiritual gifts Have you ever been water baptized? If yes, please describe when/where. Ministry Experience List ministries at Calvary Chapel Chattanooga that you have been involved in, both past and present. Include length of involvement and ministry leader for each ministry. List any cross cultural and short-term global experiences you have had. Please share length, country, ministry name and team leader of each. Also indicate if you ve ever been a short-term leader. Any/All other travel experience This Trip *How do you sense the Lord is leading you to be a part of this mission team? *What is your family s attitude towards your interest in this trip? *Your expectations greatly affect the success of a short-term mission trip. Over the months ahead, the training that you will receive will help refine your expectations. But for now, please describe your initial expectations. A COMPLETE APPLICATION PACKET INCLUDES THE FOLLOWING: This application $200 deposit (that must be paid online. No cash or check deposit will be accepted.) Answers to above questions regarding personal background, ministry experience, and this trip. Medical Release Form Liability Release Form Three color copies of your passport (this may be submitted once passport is received if you are in the process of applying for one.) Copy of your medical insurance card

7 Registration Registration is complete for a participant only when BOTH the trip deposit (paid online) and Team Member Application are turned in to the Missions Ministry. Registration can be initiated by turning in either the deposit or the application, but will not be complete and reviewable until the other component is received. To pay your deposit, visit and select your trip. Click the Deposit button, then follow the steps. Payment Schedule All payments for Calvary Chapel Chattanooga Short Term Trips should be turned in to the Missions Ministry and be made out to Calvary Chapel Chattanooga. Further details can be found in the Short-Term Mission Team Financial Policy document included in this packet. $200 deposit (paid online) Payment schedule will be given upon acceptance to the team. 100% of the cost of the trip is due no later than 7 days prior to departure Note: No refunds will be given for excess funds given. Disclaimer Please initial in the space provided as an indication of understanding and agreement of the statements. Calvary Chapel Chattanooga will not be responsible for extra trip expense (i.e., airline or hotel fare changes). Should these occur, they will be passed along to the traveler. I will agree to return home at my own expense if the Team Leader in conjunction with the Missions Ministry determines my behavior is/has been inappropriate and therefore jeopardizing the short and/or long-term ministry. I understand that my involvement on this trip can be denied prior to travel in the event that I do not participate in the full preparation of the trip (i.e., Team Member Training) and as a result could compromise the effectiveness of the trip. In submitting this application: I am expressing my agreement with Calvary Chapel Chattanooga s Vision, Mission, Values and Strategy and Statement of Beliefs. I am willing to work under the direction of the Missions Ministry, Team Leader, and Field Partners to accept and to perform any and all assignments with a Christ-honoring attitude. I am willing to conform to the standards of the national Christians, even if those standards are stricter than my own. I agree to be subject to a background check. I am confirming that I have the time and energy to devote to pre, mid and post-trip responsibilities. I agree to participate in the Short-term Team Member Training arranged by the Team Leader and complete all requirements for the trip. I have read and agree to the above deposit and payment information along with the financial guidelines described in Calvary Chapel Chattanooga s Short-Term Team Financial Policy document. Signature Date

8 Calvary Chapel Chattanooga Missions Ministry Short-Term Mission Team Financial Policy It is the desire of the Missions Ministry Staff to be good stewards of the finances we have been entrusted with. These policies were developed with that desire in mind. Mission Team Leaders are responsible for communicating these policies to team members and ensuring that all team members adhere to the payment schedule. Payment Options: Please use the online registration (WE WILL NOT ACCEPT CASH/CHECK) to make your deposit and register for the trip. Support payments can be made online or by check. Support payments can be made online to an individual on the trip. The link to enable this to happen will be provided to you by your trip leader, and be available on the website. All payments made by check should be made out to Calvary Chapel Chattanooga. A support slip with the team member s name, trip location and date must accompany the check. If a check is received without the accompanying donation slip, the funds will be applied to the team in general. Personal checks along with a support slip from the team member or by someone supporting them may be mailed to: Calvary Chapel Chattanooga, P.O. Box 2127, Chattanooga, TN ATTN: Accounting Dept. You may deliver your checks with the accompanying support slip to the church office M-F from 9am-5pm, or turn them into your team leader during one of your team meetings. The leader will then turn them into the church office. Deposits and Registration: Your registration is not confirmed until we receive your (online) deposit. Deposits are non-refundable and non-transferrable. Registration for each trip will be closed by the registration deadline listed. Payment Schedule: A detailed payment schedule will be given upon acceptance to the team. The full trip balance is due to the Missions Ministry office by the last payment deadline (Sunday before departure). Personal fund raising for trip support should begin immediately after registration is completed and you are accepted on the team. To help with this, your team leader will give you detailed information on how to raise support. Any amount received in excess of the cost of the trip will be used for other team expenses or transferred to the Global offering. No refunds will be given. Changes and Cancellations: Changes or cancellations to your registration should be communicated to the Missions Ministry Coordinator through your team leader. Payments for expenses that have already been paid are non-refundable and nontransferrable between trips.

9 Medical Release Form Team Information Trip Location: Trip Dates: Personal Information Full Name: Gender: SSN: DOB: Age: Address: City: State: Zip Code: Home Phone: Cell Phone: Parent/Guardian (if younger than 18 yrs old): Blood Type: Emergency Contact Information Please provide the name and contact information of two individuals not traveling with your team who may be contacted in the event of an emergency. Name: Relationship to you: Phone: Alt. Phone: Name: Relationship to you: Phone: Alt. Phone: Insurance Information ***Please attach a copy of the front and back of your insurance card. Insurance Company: Policy Holder: Relationship: Policy #: Group #: Ins. Co. Address: Phone: International Contact Phone Number: Do not list 800 or 888 phone numbers. They are not available for International Dialing. Medical Information Primary Care Physician: Physician Address: Phone: Primary Care Dr. and phone number if HMO: Do you have allergies or chronic illnesses? yes no

10 If yes, explain: List any other medical conditions requiring medical treatment and/or medication: List ALL medications taken on a regular basis: List all operations/serious injuries within the past five years: Have you had contact with contagious or infectious diseases within the last four weeks? yes no If yes, please explain: Have you ever had any psychiatric treatment or care? yes no If yes, please explain: What type of pain medication may be given if necessary? How would you describe your health/fitness? Excellent Good Fair Poor Additional Comments: Emergency Authorization I hereby give permission to medical personnel selected by my team leader or his/her designee (hereafter the Authorized Agent) to order X-rays, routine tests, and treatment for me. In the event of an emergency and neither my primary nor secondary contact can be reached, I hereby give permission to the physician selected by the Authorized Agent to secure proper treatment, hospitalize, order injections and/or anesthesia, and/or authorize surgery for me. I further authorize the release of the above medical information to appropriate medical personnel and/or the health coverage insurance company. In addition, I have, and do hereby, release Calvary Chapel, it s employees or agents, and in country contacts from liability associated with participation in a mission trip. I understand that if I do not have medical insurance, I will be responsible for any medical expenses in the event of a sickness or injury. I understand that there are risks involved in participating in a mission trip. Signature: Date: Signature of parent or legal guardian if under 18 years of age: Signature: Date:

11 RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK AND INDEMNITY AGREEMENT 1. This is a Release of Liability ( Release ) for the benefit of Calvary Chapel Church, Inc. known as Calvary Chapel Chattanooga, together and collectively with its related corporate entities, staff, volunteers, agents, officers, employees, sponsors, sanctioning organization, and participating ministry affiliates, all for the known purposes herein referred to as Releasees by the undersigned Releasor. 2. This Release is provided to Releasees as consideration for Releasees to all Releasor to participate in Trip Location on the dates of until approximately, herein referred to as Activity. 3. Releasor acknowledges and understands: Risks and dangers are associated with the Activity. Examples of risks may arise from transportation; lodging; recreational activities; premises liability; dangers from third parties whether or not a part of the Activity, war, insurrection, criminal acts, martyrdom, beatings, imprisonment, international incidents, terrorism, kidnapping, hostage taking; any type of negligence of Releasees; diseases, illnesses and injuries from food, water, and air; civil unrest; financial disruptions; anarchy; riots; or anything else on earth. Enumerations of examples are not intended to be exhaustive but are examples of the high risk profiles associated with the Activity. Enumeration of a known risk does not imply that a nonenumerated risk is not contemplated by this Release. 4. RELEASOR HEREBY RELEASES RELEASEES FROM ALL LIABILITY TO THE UNDERSIGNED, HIS PERSONAL REPRESENTATIVES, ASSIGNS, HEIRS, AND NEXT OF KIN FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO THE ACTIVITY, WHETHER CAUSED BY NEGLIGENCE OF THE RELEASEES OR OTHERWISE, AND IN EACH PHASE OF THE ACTIVITY FROM THE MOMENTS BEFORE THE BEGINNING TO MOMENTS AFTER ITS CONCLUSION. 5. Releasor agrees to indemnify and hold harmless the Releasees from all claims which may arise during the Activity. Releasor shall indemnify and hold harmless Releasees for all damages and/or attorney fees arising from, related to, or concerning the Activity. 6. Releasor assumes full responsibility for any risk of bodily injury, personal injury, death, property damage, or financial loss arising out of or related to the Activity whether cause by Releasees, third parties, or Releaser. 7. Releasees understand Releasor s participation in the Activity is a voluntary choice by Releasor, and being done without any compulsion by Releasees. Releasor agrees the Releasors are not insurers and any risks associated with Releasors participation in the Activity is without any insurance by Releasees.

12 I HAVE READ THE ABOVE RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK AND INDEMNITY AGREEMENT. I AGREE TO AND IT IS MY INTENTION THAT BY SIGNING THIS I DESIRE TO HAVE THIS CONSTRUED AS BROADLY AS POSSIBLE TO EFFECT MY INTENTIONS TO FULLY RELEASE RELEASEES OF ANY AND ALL LIABILITIES ARISING BEFORE, DURING, AND AFTER THE ACTIVITY, TO ASSUME ALL RISKS ARISING BEFORE, DURING, AND AFTER THE ACTIVITY, TO INDEMNIFY RELEASEES FROM ANY DAMAGES THEY MAY HAVE DUE TO MY ACTS DURING THE ACTIVITY AND TO INDEMNIFY AND HOLD HARMLESS RELEASEES FOR ANY LIABILITY CAUSED OR ATTRIBUTED TO RELEASOR. Date Releasor Signature Releasor Print Name PARENT OR GUARDIAN ACKNOWLEDGMENT (MUST BE SIGNED FOR ALL PERSONS UNDER 18) I AM THE LEGAL GUARDIAN OR PARENT OF RELEASOR, NAMED ABOVE. I HAVE READ THE FORGOING AND ON BEHALF OF RELEASOR, AND IN MY INDIVIDUAL CAPACITY I AGREE TO RELEASOR S AS WELL AS MY PERSONAL RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK AND INDEMNITY AGREEMENT. Date Signature of Parent or Guardian Print Name and Relationship