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Mission Trip Registration

El Salvador June 2025

Trip Dates:

6/21/2025 - 6/28/2025

Trip Cost:

$2,000.00

Deposit Due:

$200.00

*First Name:

*Last Name:

*Country:

*Address Line 1:

Address Line 2:

*City, State, Postal Code:

*E-mail Address:

*Phone:

Additional Information

Please note, you must submit this form with the required deposit. This form will not save to be completed at a later time or add your deposit later. If you are not prepared to pay the required deposit, please wait and complete the form at a later date. It could take approximately 30 minutes to complete and should be completed by the person applying for the team. You will need the following: a credit card to pay the required deposit, your current health insurance information, the names and contact information for 1 North Way Pastor or other staff reference and 2 character references.

Name as it appears on your passport (International trips only-otherwise N/A):

*Date of Birth:

Mobile Phone Number if different than above:

*I attend North Way (select one):

If other, what church do you attend:

*Are you in a Small Group:

YesNo

If yes, name of Small Group Leader:

*Have you completed Rooted?:

YesNo

If you have completed Rooted, what is the name of your Rooted leader?:

*Provide a name as a reference from a North Way staff person or Pastor:

*Provide name, phone and email for two character references(other than relatives)and their relationship to you:

*Please list previous Mission/International Travel Experience (Location & Year):

*Please list previous and current volunteer organizations and locations:

*Please list current church volunteer areas:

*Please list previous service projects (location and year):

*Please list any relevant skills/expertise (construction, nursing, foreign language, etc.):

*Emergency Contact: Provide name, address, phone, and relationship:

What is the state of your present health?

*Physical and environmental conditions on this trip may be different than what you are used to. Please take your current health conditions into consideration when applying for this trip.

ExcellentGoodAveragePoor

*List all health conditions you are currently experiencing:

*Allergies:

*Are you allergic to Penicillin:

YesNo

*List all medications you are currently taking:

*List all medical conditions you have had in the past with approximate dates:

*List any dietary restrictions you have:

*Do you snore:

YesNo

*Do you use tobacco:

YesNo

*Do you drink alcohol:

YesNo

*If yes to the above, please detail:

Please provide your current health insurance information (company, policy & group #s).

*International Medical Insurance is provided for all participants on international teams and is included in the cost of the trip.

*Have you been arrested for any reason or convicted of a crime? If yes please provide detail

*All Short Term Mission participants (18 and older) are required to complete and submit clearance certificates from PA State Police, PA Child Line and FBI Fingerprints or Affidavit.

Please go to www.northway.org/clearance for more information.

Have ClearancesApplied For ClearancesHave Not Applied

*In a brief paragraph, please describe your faith journey as a disciple of Jesus Christ:

*Briefly explain why you want to go on this trip, what you hope to see the Lord do in and through you & any skills you have:

Statement of Belief and Values

(Please Check to Agree) North Way Christian Community is an inter-denominational church. Our members come from many church backgrounds, both Protestant and Catholic. We are an evangelical church which holds the following tenets of belief: 1. We believe that the Bible is the Word of God and is inspired and inerrant as originally given. 2. We believe that God is eternal, three persons in One: Father, Son, and Holy Spirit. 3. We believe in the deity of the Lord Jesus Christ, His virgin birth, His sinless and perfect life, His vicarious and atoning death through His shed blood, His bodily resurrection, and His present dominion at the right hand of God the Father. 4. We believe in the present ministry of the Holy Spirit, whose indwelling enables the Christian to lead a Godly life; and whose baptism provides power for service. 5. We believe in the resurrection from the dead of both the saved and the lost; they that are saved into the resurrection of life and those that have not known God into the resurrection of judgment. 6. We believe in the spiritual unity of believers in the Lord Jesus. 7. We believe in the table of the Lord, commonly called Communion or the Lord’s Supper, for believers. 8. We believe in the personal return of the Lord Jesus Christ in power and glory to receive His church unto Himself. 9. We believe that worship is our number one priority. 10. We believe that prayer is the touchstone of our power. *Please check that you have read.

Participant Verification and Release

(Please check to agree)I recognize that North Way Christian Community is relying on the accuracy of the information I have provided on this form. Accordingly, I attest and affirm that the information I have provided is absolutely true and correct to the best of my knowledge. I authorize North Way Christian Community to contact any person or entity listed on this form and I further authorize any such person or entity to provide North Way Christian Community with information, opinions, and impressions relating to my background and qualifications. I voluntarily release North Way Christian Community and any such person or entity listed on this form from liability involving the communication of information relating to my background or qualifications. I further authorize North Way Christian Community to conduct a criminal background investigation, as I understand this to be a standard practice for these activities. I further accept and confirm that I have read, accept and shall follow the *Statement of Beliefs and Values as noted above. I understand I will receive a copy of the policy and procedures of the organization and agree to read and abide by them. Should I have questions or concerns, I shall contact the trip leader to discuss.

*Agreement and Understanding:

(Please check to agree)I understand and agree that if I am accepted for this mission trip, it will be my responsibility to raise the funds set by the given deadlines. I understand that raising the funds will take substantial effort on my part. In the event I decide to write support letters to my family and friends, I will provide a copy of the support letter to North Way Christian Community for approval. I understand that all deposits, contributions and fundraiser sales are received as a donation to the trip total, are tax deductible and non-refundable and non-transferable, and that North Way Christian Community has complete and total discretion and control over the use of all donated funds. If I cannot go on the trip, for whatever reason, or if I raise funds in excess of the trip goal total, I understand that donated funds will not be returned to donors and cannot be used for personal expenses. I further understand that training for this trip will require several preparatory meetings, and I commit to attend all of the established training meetings.

Next Back to Mission Trips

Mission Trip Registration

El Salvador June 2025

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