Short-Term Missionary Application

mark.devine@calvaryoceanside.org
(760) 754-1234

*If you are under 18 years of age, a parent/guardian must assist with the completion of this form in its entirety.*

Your name *

Email address *

Please enter full legal name as it appears on your passport:

Address

Phone number

Occupation:

Birthdate

Age

Birth Place:

Passport Number:

Issued From:

Expiration Date:

Drivers License Number:

State & Expiration:

*Please upload a copy of your driver's license and passport to this application or email a copy to mark.devine@calvaryoceanside.org.

Emergency Contact Information

Please provide 2 contacts

Contact 1:

Address

Relationship to emergency contact:

Contact 2:

Address

Relationship to emergency contact:

Beneficiary Name & Phone Number (required for insurance purposes) *

Health

It's your responsibility for innoculations and vaccines prior to going on a mission; contact the State Department for their recommendations.

* On a mission, always bring extra medications and glasses.

What is your general health?

Do you have any physical conditions which may limit your ability to perform the ministry for which you have applied?

If yes, explain.

Are you currently under medication prescribed by a physician?

yes

List any chronic disease, allergies or dietary restrictions you have:

Medical Contact Information

Doctor's Name and Phone Number

Dentist's Name and Phone Number

I have voluntarily provided the above contact information and authorize Calvary Chapel Oceanside staff to contact any of the above on my behalf in the event of an emergency.

Signature

Testimony

When did you become a Christian?

What is the name of your home church?

In what areas are you serving in your local body?

Have you ever been on a mission trip? If so, where and why?

What church or organization did you go with?

Give your brief testimony and present relationship with Jesus Christ:

What are your goals for this mission trip?

References

1. Pastor: Church: Years Acquainted:

Address

Phone number

Pastors email:

2. Mature Christian: Years Acquainted:

Address

Phone number

*Please Read Through Thoroughly

I certify that all the above information is true and I have answered each question completely and honestly. I understand that on this ministry trip, I will be a representative of Calvary Chapel Oceanside and will therefore conduct myself as a mature believer. I further state that I have carefully read and answered the questions above and understand its contents, and I voluntarily initial and sign this release as my own free act.
I waive, hold harmless, and release any and all claims for damages which I, or my heirs or successors, may have against, Calvary Chapel Oceanside or any agent or employee of any of such organization, arising from my death, injury, or illness, or any property damage or loss occurring during the term of my assignment or as a result of my assignment. Calvary Chapel Oceanside is a corporation and all risk are between the corporation and the applicant. No individual / person is responsible for the risks associated with travel to a foreign country.
The applicant is aware of risks and assumes full responsibility for safety, health, welfare and financially. The applicant assumes all liability of dangers associated with traveling to a foreign country.

Typing your name here is your signature that you have read and agree with the above statements.

Date of signature:

Code of Conduct

Because we are representing Jesus Christ at all times, we will set and maintain the highest standard of conduct according to 1 Timothy 4:12 which says, “Don’t let anyone look down on you because you are young but set an example for the believers in speech, in life, in love, in faith and in purity.”

Because I am aware of my witness I will guard my conduct
(1) in my speech: No swearing or coarse language.
(2) in my deeds: No purchasing or partaking of any kind of alcoholic beverages, any form of tobacco, or any kinds of drugs.
(3) in my faith: No inappropriate or compromising behavior that would damage the reputation and testimony of the team, the leadership, the national church or the ministry of Calvary Chapel Oceanside.

Be imitators of God, therefore, as dearly loved children and live a life of love, just as Christ loved us and gave himself up for us as a fragrant offering and sacrifice to God. But among you there must not be even a hint of sexual immorality, or of any kind of impurity, or of greed, because these are improper for God’s holy people. Nor should there be obscenity, foolish talk or coarse joking, which are out of place, but rather thanksgiving. Eph 5:1-4

Here are some basic rules that apply to every ministry trip:

Be fully aware of these rules and regulations so you can follow them. It does not matter what has happened on other Calvary Chapel Oceanside ministry trips; each trip is unique and different—even to the same place! Make an extra effort to be an example of Jesus Christ in every area of your life as you interact not just with the nationals, but also with your fellow team members.

Note: Any violation of these rules may result in immediate dismissal from the team and the trip. A direct flight home will be arranged, and will be at your own expense.

A) No Inappropriate relationship with the opposite sex. Avoid all questionable situations being culturally sensitive. When staying at hotels or similar housing, stay out of the room of a member of the opposite sex. Avoid being alone with a member of the opposite sex.
B) Show respect for your team leaders, the national church and leaders, and other team members. Show a Christ-like attitude by treating others the way you would like to be treated. Be forgiving, understanding and especially longsuffering. This ministry trip will be short; you do not have time to be inconsiderate or indifferent.
C) Be accountable. Make sure your leaders and team members know where you are at all times. Be on time or early to all appointments.
D) Maintain and keep your witness at all times. Remember we are representing Jesus Christ.

I understand the rules and regulations set forth by Calvary Chapel Oceanside in this Code of Conduct regarding my behavior on this mission trip. I will do my utmost to willingly and joyfully abide by this Code of Conduct, maintaining the highest standard and positive witness. I understand the possible consequences set forth of immediate dismissal from the team and the ministry trip at my own expense for direct return home. I understand that on this ministry trip I will be a representative of Calvary Chapel Oceanside and will therefore conduct myself as a mature believer.

Typing your name here is your signature that you have read and agree with the above statements.

Date of Signature:

Assumption of Risk

In consideration of my acceptance as a short-term volunteer with this Calvary Chapel Oceanside ministry trip represent and agree that:

I am a volunteer worker and acknowledge that I am not an employee of Calvary Chapel Oceanside.

I am aware of the hazards and risks to my person and property associated with serving in a mission’s capacity, such hazards and risks including, but not being limited to: death or injury by accident, disease, weather conditions, inadequate medical services and supplies, criminal activity, and random acts of violence or terrorism. Specifically, I voluntarily assume any and all risks that I may be detained and/or incarcerated by the authorities of the country or countries where I travel while engaged in my volunteer duties on behalf of Calvary Chapel Oceanside. I understand that it is the policy of Calvary Chapel Oceanside that in cases of kidnapping, hostage-taking or other extortion, no ransom concession that is reasonably likely to cause or contribute to the probability that future similar events will occur shall be paid or made.

I attest and certify that I have no medical conditions that would prevent me from performing my duties.

In the event that I have minor children who will accompany me on my assignment, I, acting both on my own behalf and in their behalf as their parent and legal guardian, and subject to the insurance coverage described below, do hereby assume all risks of death, illness, or injury that they may suffer as a result of said assignment, from those causes described above.

I expressly waive any defense to the enforcement of any provision of this commitment arising from a claim of lack of consideration and warrant that this commitment constitutes a legal, valid and binding obligation upon me enforceable against me in accordance with its terms.

I expressly agree that this assumption of risk and indemnity agreement is intended to be as broad and inclusive as permitted by law. I further state that I have carefully read the foregoing assumption of risk and understand its contents and I voluntarily initial and sign this release as my own free act.

Please Note:

A parent/guardian must sign if you are under the age of 18.

Typing your name here is your signature that you have read and agree with the above statements.

Date of Signature:

Have spouse type their name here is their signature that they have read and agree with the above statements.

Date of Signature:

Permission to Treat

In the event that I become incapacitated and am unable to order medical treatment on my own behalf, I authorize and consent to an X-ray examination, anesthetic, medical or surgical diagnosis treatment and hospital care to be rendered to me under the general or special supervision and on the advice of a licensed physician, surgeon, anesthesiologist, dentist, or other qualified medical personnel acting under detrimental to my health and well-being.
The undersigned warrants that he/she has fully read and understands this Permission to Treat agreement and voluntarily signs the same, and that no oral representations, statements, or inducements apart from the foregoing written agreement have been made to the undersigned.

Typing your name here is your signature that you have read and agree with the above statements. * A parent or guardian MUST sign on your behalf if you are under the age of 18.

Date of Signature:

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