Please type your name as it appears on your driver's license and passport.

Please upload a photo of your passport with the book open and both pages visible. If you do not have your passport yet, please upload a picture of yourself.

Please note that one of your required references must be submitted by the pastor of your church in order to participate in a Bartlett Baptist mission trip as a non-member.

Check all that apply.

Please check all that apply.

If you answered no to any of the above, you or your legal guardian (if under 18) assumes all responsibility if an illness is contracted on the trip.

In consideration for being allowed to participate in activities sponsored by Bartlett Baptist Church, I hereby release, discharge, indemnify, and agree to hold harmless Bartlett Baptist Church, its directors, officers, employees, and all volunteer personnel from any and all liability for personal injuries and/or damage(s), injury or illness that I may suffer. I further agree to indemnify and hold harmless Bartlett Baptist Church, its directors, officers, employees, agents, and all volunteer personnel for any claim and/or damages it, or its agents are required to pay as a result of any injury or damages including attorney fees, litigation expenses and court costs.

MISSION TRIP APPLICATION FORM

EMERGENCY CONTACT INFORMATION

MEDICAL INFORMATION

PERSONAL RESPONSE

References

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