Thousand Hills Ministry Mission Trip Agreement Form

Thousand Hills Ministry Mission Trip Agreement Form
Contact Person*

First NameLast Name
Date of Birth*

MonthDayYear
Gender*
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Short Bio
Home Church
Occupation
Top 3 Skills
Passport Number*
Country of Passport*
Passport Expiration*

MonthDayYear
Copy of Passport*

Upload a File

Cancelof
Weight*
Please be honest as this is critical information for our pilots
Medical Conditions*
Please type "none" if there aren't any
Malaria Medication

YesNo
Emergency Contact*

First NameLast Name
Emergency Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Email*
Please open and read the two documents below.

Waiver of Liability & Consent

Trip Code of Conduct

How it works: By entering your name and initials below, you electronically acknowledge reading and understanding the above documents.
Digital Signature*

First NameLast Name
Initials*
Should be Empty: