r APPLICATION: Complete with all medical info, insurance info, testimony, and parent/student signatures.

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TRIP DATES: April 2 - April 6, 2018 Application Deadline: Sunday, December 10, 2017 Cost: $275 r APPLICATION: Complete with all medical info, insurance info, testimony, and parent/student signatures. r r MARK CALENDARS FOR MEETING DATES: PASTOR KYLE WILL SCHEDULE AN INTERVIEW: Talk about commitment. Your application does not guarantee you a spot, it is simply putting your yes on the table to go. Spots are limited and every eligible applicant may not be able to go. We desire for every eligible student to go, but remember a mission trip is not a right, it is a privilege. By committing to this trip, you are also committing to at least an 80% small group and an 80% Student Worship attendance, as well as attending all training meetings prior to the trip (one pre-excused meeting absence per team member may be allowed). Meetings dates are 1/14, 1/28, 2/25, 3/25 - lasting from 12:30pm-3:00pm.

Name of participant: Gender: ( ) Male ( ) Female Address: Student Cell Phone: Parent/Guardian Cell Phone: Student Email (please write very clearly): Parent Email: Date of Birth: PROJECT PARTICIPATION AGREEMENT By committing to this trip, I am also committing to at least an 80% small group and an 80% Sunday morning attendance, as well as attend all training meetings prior to the trip (one pre-excused meeting absence per team member may be allowed). Meetings dates are 1/14, 1/28, 2/25, 3/25 - lasting from 12:30pm-3:00pm. Missing these meeting without prior permission given by Pastor Kyle can result in disqualification from the trip. Upon disqualification or dropping out of the trip for unforeseen reasons, any money paid toward the trip will go to the general student mission trip fund and cannot be refunded. By signing below, you accept these terms. Participant s Signature: Date: Parent/guardian signature: (name) (signature) Please list any meeting date that you already have a known scheduling conflict with, followed by a description. Meeting Date: Reason for Conflict: 2

PARTICIPANT MEDICAL INFORMATION Is sponsor authorized to approve medical treatment? ( ) Yes ( ) No Is participant covered by personal/family medical insurance? ( ) Yes ( ) No If yes, name the insurer: Policy or group number: *Please attach a copy of your insurance card. How would you describe your present health? ( ) Excellent ( ) Good ( ) Average ( ) Poor Please state any major illness(es) you have had in the last five years Are you presently under the care of a physician for any ongoing illness or condition? ( ) Yes ( ) No If yes, please explain Please list any medication you are taking regularly: Please list any allergies you have (including food) and how severe: Please explain any physical challenges that you may face on this ministry trip: Emergency contact: Telephone: (day) (night) PARTICIPATION AGREEMENT By signing below, the participant (or parent/guardian if participant is a minor) acknowledges and accepts the risks of physical injury associated with participation in the activity described above. The participant (or parent/guardian) accepts personal financial responsibility for any bodily or personal injury sustained during the activity. Further, the participant (or parent/guardian) promises to hold harmless the sponsoring organization (Christ Community Church Huntersville, NC) and its representatives for any injury related to the activity. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable arbitration process. Participant s Signature: Date: Parent/guardian: (name) (signature) 3

INVOLVEMENT What does it mean for a Christian to be on mission : How does being on mission effect your relationship with Christ? Why is being committed to a small group important? Why does our church make such a big deal about Small Groups? What aspects of your personality do you bring to this team and why? What aspects about this trip make you uncomfortable and how are you willing to let God use those to grow you? Why does the Church do mission trips? When was the last time you talked to someone about your relationship with Jesus? Tell us about that experience: On a personal level, what does your weekly relationship with God look like (bible reading, prayer, worship, evangelism, discipleship), what has God been teaching you through them, and why are they important in your walk with God? Are you a current member of a Small Group? Name of your leaders How often do you attend your group? 4

PERSONAL TESTIMONY How was your life before coming to Jesus? What does it mean to surrender to Jesus as your Lord and savior? What did that look like in your heart? How is your life now that you know Him? How did that effect your heart? In what areas of your life have you seen spiritual growth over the past few months? What has God been teaching you this school year? Briefly describe why you want to be involved with this trip. What aspects of your personality could you use to serve our mission team? 5

PARENT PERMISSION AFFIDAVIT FORM In consideration for participating on the following CHRIST COMMUNITY CHURCH short-term mission project: I hereby give my son/daughter permission to travel to and from the Metro-Atlanta area with CHRIST COMMUNITY CHURCH and its representatives. I also authorize CHRIST COMMUNITY CHURCH and its representatives to initiate any medically necessary care on my son/daughter s behalf in the event of my son/daughter s incapability to present himself/herself for such care. I agree to be financially responsible to any care provider and I authorize the release of any necessary medical or insurance related information pertinent to the circumstances. Name of Participant Signature Date If Minor, BOTH Parents or legal Guardians must sign (unless guardian has full custody; please make a note): Name Signature Date Name Signature Date 6

FAQ S (DETATCH AND KEEP) - How much money will I need to raise to go on the trip? The cost of the trip, including your $50 deposit (due December 20) is $275. We will go over support raising at the first meeting. - When is the deadline to raise all funds for the trip? March 25 th. - What does the cost of the trip cover? The $275 cost covers travel, lodging, meals, t-shirts, and ministry supplies. - Will I be able to call/text my student while they are on the trip? Your student will not be allowed to use their phone. On a trip like this, a phone call home, texting, and social media can make a student feel homesick or become distracted from the mission or checked- out from their teammates. We don t want your student missing out on any of this amazing opportunity for growth and ministry. However, we will update our Student Facebook Page daily with pictures and a ministry recap. If there is a family emergency, and you need to contact your student, there will be emergency contact info provided during the final parent meeting before the trip. - Where will the team be staying? We will book rooms in a hotel only a few minutes from the church we are partnering with. - What will the team be doing for ministry? Our Middle School Mission team will partner with a church revitalization associated with the North American Mission board in the Alpharetta area to reach their community and point them to a gospel-centered fellowship. - Who is leading the trip? Pastor Kyle will be the trip leader, and there will also be additional adult leaders to disciple our team of students. All of the leaders have experience in student mission trips. We have a great team! - What if my student has special needs such as insulin shots or dietary needs? Please let us know head of time, our adult leaders will be briefed on how they can help your student remain healthy during the trip. - Will my student be trained before going on this trip? YES! Your student will not only be trained thoroughly for this trip (everything from team building, missions perspective, and ministry prep) but also discipled intentionally in their faith. Your student WILL experience amazing spiritual growth throughout the months of training and during this life-changing trip. - What happens if I raise money and don t end up going? Your student is not simply raising money for themselves as an individual; your student is raising money as a part of the team with a ministry goal. In the past, some students have raised above and beyond, and have been able to bless other team members who are struggling to raise funds even though they have been working hard. This is the model that has been laid down for us in the New Testament. If for some reason you have already raised funds and are either disqualified from the trip due to behavior issues, or you simply have to drop out for unforeseen reasons, the money that you raised cannot be refunded. All money raised goes towards missions, not the student. - How serious do you take the training meetings? By committing to this trip, you are also committing to at least an 80% small group and an 80% Sunday morning attendance, as well as attend all training meetings prior to the trip (one pre-excused meeting absence per team member). Meetings dates are 1/14, 1/28, 2/25, 3/25 - lasting from 12:30pm-3:00pm. 7