Restoration Church Mission Trip Application for Minors

Please fill out this form and click submit.
*Applications must be submitted by Wednesday, October 22 at 9:00 AM.
Due to the nature of this trip and due to the expected number of students wanting to be a part of this mission trip, we have to be very thorough in our application process. Thank you for your transparency in answering each question thoroughly. If you are uncomfortable answering any question via this form, please let us know (Email us at aaron@rcwausau.org or nicole@rcwausau.org).
General Information

(Information MUST match what is on your passport.)
 
 
 
 
 
 
 
 
 
Parent Contact Information

Parent #1:
 
 
 
 
 
Parent #2
 
 
 
 
 
Emergency Contacts

(Do not list someone who will be on the trip with you.)
Emergency Contact #1
 
 
 
 
 
 
 
Emergency Contact #2
 
 
 
 
 
 
 
Insurance Information

 
 
 
 
 
Application

(Please expound on your answers.)
In our effort to serve the Restoration Church community, our missionaries, as well as the world faithfully, we must take into consideration the following information:
Please select one option.
 
 
 
 
 
 
 
 
 
5. Please list the name of a Restoration Church staff member, elder, or youth leader who can serve as a character reference for you:
 
 
 
6. Please list the name of an adult (other than family) who is willing to serve as a character reference for you:
 
 
 
 
 
 
 
 
 
Please select one option.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
18. Participation in this trip requires students to commit to the following: (Please initial beside each one you are willing to commit to.)
 
 
 
 
 
 
 
 

Description

Please fill out this form and click submit.