Thousand Hills Ministry Mission Trip Agreement Form

Thousand Hills Ministry Mission Trip Agreement Form
Contact Person *

First Name Last Name
Date of Birth *

- Month - Day Year
Gender *
E-mail *
Phone Number *

- Area Code Phone Number

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Short Bio
Home Church
Occupation
Top 3 Skills
Passport Number *
Country of Passport *
Passport Expiration *

- Month - Day Year
Copy of Passport *
Weight *
Please be honest as this is critical information for our pilots
Medical Conditions *
Please type "none" if there aren't any
Malaria Medication

Yes No
Emergency Contact *

First Name Last Name

Emergency Contact Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Emergency Contact Phone Number *

- Area Code Phone 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 Name Last Name
Initials *
Should be Empty:

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