Puente de Amistad Team Member Application: Adult

Puente de Amistad Team Member Application

STOP! DO NOT CONTINUE WITH THIS APPLICATION WITHOUT A PDF COPY OF YOUR PASSPORT AVAILABLE TO DOWNLOAD! THIS IS A REQUIRED FEILD!
Team Member Full Name*

Last NameFirst NameMiddle Name
TEAM LEADER & TEAM INFORMATION
What is my Team's Name (What do you call yourselves?)
Team Leaders Name

First NameLast Name
Team Leaders E-mail
example@example.com
TEAM MEMBER INFORMATION
Spouse's Full Name (N/A if not applicable)

First NameMiddle NameLast Name
Team Member Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Team Member Phone Number (Home)*

Area CodePhone Number
Team Member Phone Number (Cell)*

Area CodePhone Number
Team Member E-mail *
example@gmail.com
Team Member Birth Date:*

MonthDayYear
Date
Team Member Age:*
Team Member Gender:*

MaleFemale
Church Information
Church Full Name*
Church Phone Number*

Area CodePhone Number
Church E-Mail Address*
example@example.com
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information
Emergency Contact Name:*
Relationship with Emergency Contact:*
Emergency Contact Phone Number:*

Area CodePhone Number
Personal Identification Questions
Mother's Maiden Name:*
Favorite Sport:*
Favorite color:*
Employer:*
City of Employment:*
Type of Work:*
Have you been on an overseas mission trip in the past?*

YESNO
If "YES", please list the places you have gone:
Do you have a Passport?*

YESNO
If "YES" to having a passport, what is the expiration date?

MonthDayYear
Date
Do you have a Passport Card?*

YESNO
If "YES" to having a passport card, what is the expiration date?

MonthDayYear
Date
Passport Number/ Passport Card Number:
Please Note:

A scanned copy of your passport/passport card is a requirement of Puente de Amistad.

This is not a suggestion!!!
Upload a copy of your passport book or passport card: (Passport Book: Needs to be of your photo and all the personal information)*
*PDF format. *Needs to be of your photo and all your information
A good copy of your Passport is for your benefit! In the case of your passport or passport card being stolen or lost, you will need a copy to return to the United States of America. It is in your best interest to make the copy as professional as possible. Scanned Copies are preferred by the Border Guards.
If you do not have a Passport or a Passport Card you need to apply for one immediately.

You will not be allowed to stay at Puente de Amistad without one of these forms of identification.
Medical Information
*This information will not be used to determine eligibility. It is important for your safety while you are on the trip.
My overall physical condition is:*

ExcellentFairGoodPoor
If your answer was anything other than "Excellent", please explain why:
List all medications that you are taking and their purpose
Height:*
Weight:*
Doctor's Name*
Doctor's Phone Number

Area CodePhone Number
Date of last Tetanus Inoculation:

MonthDayYear
Date
Health Insurance Carrier:
Health Insurance ID Number:
Group Number:
Is your medical insurance valid outside of the United States?

YESNO
Puente de Amistad Waiver of Liability, Code of Conduct, and Team Covenant

Adult Waiver of Liability
Waiver of Liability

The undersigned does hereby consent to take part in the noted activity organized by Puente de Amistad, a ministry of Open Bible Standard Churches, a religious, non-profit corporation. I have been informed that a foreign country is very different from the United States. I have been apprised that there are risks politically, militarily, culturally, safety-wise, and health-wise and that problems in any or all of these areas may arise during this mission trip. I have been apprised that, in Tijuana, Mexico, there is currently an added risk of rapid kidnappings and other violent crimes, which are mainly related to criminal activity with drug cartels. In addition, I have been apprised that the threat of terrorism against Americans increases on foreign soil. I am also aware of the threat of terrorism in air travel both from American and foreign airports. I also understand that this trip will involve mission activities, sporting activities, and interaction directly with people while on this trip. I am willing to assume responsibility for my own health and safety while traveling to and from the mission trip destination. I agree to assume all expenses occasioned by any injury or loss and do wholly release Open Bible Standard Churches and Puente de Amistad from any responsibility or liability, and waive any claims or causes of action against it, its agents, employees, and volunteer assistants that may arise on account of any loss, injury, or expense occasioned by any sort of accident or other circumstances involving any foreign or travel risk and agree to hold harmless Open Bible Standard Churches and Puente de Amistad in the event any such claims should arise.

The undersigned agrees to abide by the rules and regulations, supervision, and discipline set and applied by Open Bible Standard Churches, Puente de Amistad, and its agents and does hereby authorize Puente de Amistad or its staff members or other agents to arrange for and consent to x-ray examinations, anesthetic, dental, medical, or surgical diagnosis, and treatment, and hold harmless Puente de Amistad and Open Bible Standard Churches from any such. The undersigned will furnish payment or insurance for any such treatments at his/her own expense. I have read the above waiver of liability and completed the medical information. I understand its content and import and agree to its provisions. I hereby declare this release and Waiver of Liability form is executed without reliance upon any statement or representation of Open Bible Standard Churches or Puente de Amistad or any agent, employee, or volunteer thereof and the execution is made voluntarily and knowingly.

Important Advisory: Individuals traveling to a foreign country and reentering the U.S. are advised that having illegal substances (drugs) or illegal merchandise in their possession will subject them to severe penalties including fines and imprisonment as prescribed by each country. Violation of such laws overseas often results in automatic and lengthy prison terms.
Code of Conduct

As a Christ-centered ministry base under the auspices of Open Bible Churches, Puente de Amistad bases its values and code of conduct concerning human sexuality and gender upon its understanding of biblical standards.

 Accordingly, all staff, volunteers, and guests are not permitted to publicly identify or present as a gender that differs from their biological sex or sex assigned at birth or to request pronouns of their preference.

 All staff, volunteer and guest correspondence, documents, and records will reflect their biological sex.

 All staff, volunteers, and guests will use bathrooms that correspond with their biological sex while at the base of Puente de Amistad or while participating in programed activities outside the base.

 Puente de Amistad believes in the sanctity of sex as reserved for marriage between a biological man and a biological woman and prohibits both heterosexual sexual intimacies outside of marriage and same-sex displays of
affection by staff, volunteer or guests.

 Failure to comply with this code of conduct or speaking out against it as a staff member, volunteer or a guest at Puente de Amistad will be cause for loss of staff position, volunteer’s position or guest privileges and dismissal from the premises.
Team Covenant

I having been told and fully understand what will be expected of me while in Tijuana, and do hereby give my word to adhere to the following:

1. Respect the people and culture of Mexico, and abide by Mexican laws, both legal and social;

2. Obey our authorities and respect each member of the team as well as others we may work with on the trip;

3. Abide by the rules of Puente de Amistad and do nothing that could damage the reputation of Open Bible in Tijuana;

4. Maintain a positive attitude despite hardships and inconveniences;

5. Set aside romantic interests in other team members or people we may meet on the trip until after the trip is over;

6. Pray for team members on a daily basis; and

7. Attempt with all of our being to follow the example of Jesus Christ in all things.
Team Member's Printed Name*

First NameLast Name
*By signing in this box, you are stating that you have read the "Team Member Guide" and agree to follow all the rules, terms, policies, and pay agreements set forth by Puente de Amistad, either in the "Team Leader Manual", "Team Member Guide", or Puente de Amistad's (websitepdeamistad.org).
Team Member's Signature*
Date/Time*
Should be Empty:

Puente de Amistad Team Member Application

TEAM LEADER & TEAM INFORMATION

TEAM MEMBER INFORMATION

Church Information

Emergency Contact Information

Personal Identification Questions

Medical Information

Puente de Amistad Waiver of Liability, Code of Conduct, and Team Covenant