Team Member Application Form

Team Name:

* First Name:

* Last Name:

* Birth Date:

* Age:

* Current Grade/Level of Education:

* Male/Female:
Select OneMaleFemale

* T-Shirt Size:
Select OneS (Adult)M (Adult)L (Adult)XL (Adult)XXL (Adult)XXXL (Adult)

* Street Address:

* City:

* State:

* Zip Code:

* Home Phone Number:

* Cell Phone Number:

* EMail Address:

* Country/Countries of Your Citizenship:

* Marital Status:
Select OneSingleMarried

* Father's Name (Guardian):

* Mother's Name (Guardian):

* Parent's Email Address if you will be UNDER the age of 18 by the start date of the trip. Your email address if you will be OVER the age of 18 by the start date of the trip:

* Briefly describe how you began your relationship with Jesus Christ:

* How is God currently working in your life?

* Please describe your previous ministry experiences:

* What ministries are you currently involved with?

* Please describe your previous short term missions experiences:

* Please list your gifts or skills:

* Why do you want to participate on this trip?

* How would you like to see God work IN you personally during this trip?

* How would you like to see God work THROUGH you during this trip?

Please read each of the items of the Participant Covenant below. Checking each box is your indication that you agree with and commit to that covenant item. Please refer to the Trip Policies page if you have any questions. Thank you.

I have a growing relationship with Jesus Christ.

I agree to do all that I can to pursue the 3 objectives that have been established for this trip.

I promise to complete all preparation requirements and to fully participate in all preparation meetings.

I understand that cell phones, pagers, MP3 players, computer games, and all other electronic devices are not permitted on the trip.

I understand that dating relationships and romantic/sexual pursuits are not permitted during the trip.

I will not complain during the trip and will do my best to have a flexible and teachable attitude.

I will submit to all trip leaders and staff.

I will not use profanity during the trip.

I will not use and/or purchase alcohol, drugs, tobacco, or particpate in any illegal activity during the trip.

I will adhere to the dress code.

I will follow all safety guidelines given to me during this trip.

I understand that I am not permitted to leave our base for any unapproved reason, i.e., going out for a run.

I approve the use of my pictures, video and testimonies in future promotional materials for TCSTM.

I understand that by breaking this covenant, TCSTM and/or my group leader will dismiss me from the team. If an infraction occurs during the trip, TCSTM and/or my group leader will send me home at my own expense and any money paid will be forfeited.

* Person to contact in the event of an emergency:

* Home Phone Number of your Emergency Contact:

* Cell Phone Number of your Emergency Contact:

* Street Address of your Emergency Contact:

* State of Residence of your Emergency Contact:

* ZIP Code of your Emergency Contact:

* What is the Name of your Medical Insurance Company?

* What is your Medical Insurance Policy Type?

* What is the Policy Number of your Medical Insurance?

* What is your Doctor's Name:

* What is your Doctor's Phone Number:

* What is the Date of your Last Physical Examination?

* What is the Date of your Last Tetanus Shot?

* Please List any Allergies?

* Please list any major illnesses in the past year:

* Please list any medications you will be taking during the trip and the dosages:

* Are there any conditions we should be aware of?