Test Form SHORT-TERM MISSION TRIP APPLICATION & RELEASE WE CANNOT ACCEPT HANDWRITTEN APPLICATIONS. If you are 16 years of age or younger, you must have a parent or other adult who will be responsible for you while on this mission trip. Dates of mission trip for which you are applying:* MM slash DD slash YYYY Number of SHIP trips to El Salvador you’ve been on:*Full Name (EXACTLY as it appears on passport):* Name you prefer to be called: Gender Male Female U.S. Citizen Yes No Passport ID: Date Issued: Expiration Date: Birthdate: MM slash DD slash YYYY Marital Status Single Married Permanent Mailing Address: Phone: (Home) (Cell) (Work) E-mail: Do you speak Spanish? Yes No If “yes”: Fluently Conversationally Just a little List your skills (such as musical instruments, singing, construction, sports, dancing, crafts, sewing, etc.), talents, or experience, which may be helpful on this trip.MINISTRY INFORMATION(If you’ve completed this SHIP application form for a previous SHIP trip, you do not need to complete the Ministry Information/References sections again unless there is a change in your information.)Church Member? Yes No If so, where? List the ministries with which you have been active at your church, including time of involvement and leadership positions.List the service or leadership activities with which you have been involved outside of church, including time of involvement and leadership positions.What do you think your spiritual gifts are?Have you gone on previous mission trips? Yes No If yes, list the three most recent trips below.Where? With what organization? Trip Dates? Ministry activities while there? Where? With what organization? Trip Dates? Ministry activitiws while there? Where? With what organization? Trip dates? Ministry activities while there? Please share your salvation testimony. Specify how long you have been a believer.Explain how a person becomes a Christian.Describe your walk with the Lord at the present time.Tell us why you desire to go on this mission trip. What do you hope to see the Lord accomplish in and through you?ReferencesPlease provide two references below.Reference 1: Church pastor or director in a ministry in which you serve.Name Relationship to you: Phone Number Reference 2: Someone who knows your abilities as well as your strengths and weaknesses.Name Relationship to you Phone Number BackgroundHave you ever been convicted of or pleaded guilty to a criminal offense that would include the sale or use of drugs, child abuse, alcohol consumption, or crime involving actual or attempted sexual misconduct?Answering “yes” does not necessarily disqualify you from the trip. Yes No If “yes,” please explain:Driver’s License number: State Restrictions Social Security Number The training meetings for this mission trip are critical, ensuring success for your entire team. Do you commit to faithfully attend at the scheduled times? Yes No T-shirt size for your SHIP trip shirt: Photo/Video ReleaseBy signing this application form, I hereby grant permission to SHIP to the rights, without payment or any other consideration, of my image, likeness, and sound of my voice as recorded on audio or video tape. Photographic, audio, or video recordings may be used by SHIP for the following purposes: informational presentations, promotional materials, newsletters, website, Facebook, Twitter, and Instagram.Notice of Understanding Completion of this application may not necessarily guarantee a place on the respective mission trip. Each application will be reviewed by SHIP’s staff.Financial Notice of Understanding It is my responsibility to secure the necessary finances for the mission trip. In the event that I raise funds for the mission trip that exceed its cost, the excess funds will be considered a donation to SHIP’s work in El Salvador. Donations made to SHIP are considered charitable contributions for federal income tax purposes to the extent permitted by law. If, for some reason, you do not participate on the mission trip to which you have been accepted, you may apply the SHIP fee toward another SHIP mission trip, if taken within one year of cancellation. Cancellation Policy: Your deposit is non-refundable. After the full SHIP fee has been paid (not through donations from a third party), refunds of the remaining portion of the fee will be made dependent upon the date of cancellation: If cancelled 30 days or more before the trip: 100% If cancelled 21-29 days before the trip: 75% If cancelled 14-20 days before the trip: 50% If cancelled 7-13 days before the trip: 25% If cancelled 0-6 days before the trip: 0% Extenuating circumstances (illness, death of a family member, etc.) for trip cancellation will be reviewed by SHIP on a case-by-case basis. I understand that the team leader(s) reserves the right to ask me to return home if my behavior is destructive to the team, the ministry, or the host community. Any additional costs incurred, as a result of this action, will be my responsibility.Gift-giving PolicyMany of the children and families SHIP works with live on less than $2 a day. We restrict the size of monetary gifts to avoid creating opportunities for dependence and to avoid fostering jealousy within the community, which could place a child and his or her family at risk. Our goal is to stop the cycle of poverty that stalks families from one generation to the next, and we do this by equipping children with the skills they need to be successful in their own right. Please read the following guidelines: Gifts brought on SHIP mission trips (candy, clothing) should be in sufficient quantity to share with every child. If you need clarification regarding these types of gifts, contact SHIP. No money or other gifts may be given to children, unless those gifts are given by the child’s sponsor and in accordance with SHIP’s sponsorSHIP guidelines. SHIP’s sponsorSHIP students and parents sign a contract at the beginning of each school year that prohibits students and/or parents from requesting and/or accepting gifts from their sponsors or others without the express written consent of SHIP. Students and/or parents who disregard this rule will be immediately dismissed from the SHIP sponsorSHIP program. Note: SHIP will never hand over cash gift money to sponsorSHIP students or their families. Instead, SHIP will make purchases according to the need of the sponsored child and family.AuthorizationThe information on this application form and on any attached forms is correct to the best of my knowledge. Additionally, I have read and agree to the Photo/Video Release, Notice of Understanding, Financial Notice of Understanding, and Gift-giving Policy. I authorize SHIP to perform a criminal background check. I authorize any references to release all such information, as it will assist in the evaluation of my participation on a SHIP mission trip. I release all references from liability for any damage that may result from furnishing such information to SHIP. I waive any right that I may have to inspect references or the background check. I hereby give SHIP permission to contact my references and appropriate government agencies. I have read and agree to abide by the policies set forth on the form, SHIP Policies for International Short-Term Mission Trips, and I support SHIP’s Statement of Faith (located at https://shipinternational.org/mission-trips/applications-forms/).Date MM slash DD slash YYYY Printed Name of Participant Signature of ParticipantMax. file size: 50 MB.If the applicant is a minor (under 18 years old) or is still in high school:Date MM slash DD slash YYYY Printed name of Parent/Legal Guardian Signature of Parent/Legal GuardianMax. file size: 50 MB.Please print, sign, and return all forms, along with the required deposit, to: SHIP International PO Box 3003 Bryan, TX 77805Short-Term Mission Trip Medical and Liability ReleaseName (EXACTLY as shown on passport): Complete Address Birthdate MM slash DD slash YYYY Phone (Home) Phone (Cell) Phone (Work) EMERGENCY CONTACT (For those younger than 18 years of age or still in high school, provide parent/guardian info.)Name Relationship Phone(Home) (Cell) (Work) Complete Address Email MEDICAL INFORMATION (SHIP will provide international medical insurance through MissionTripInsurance.com.)State of your present health: Excellent Good Average Poor If you have any medical problems, regularly use any medication, have a special diet or allergies (including allergies to medications), or have had a major illness or surgery within the last 12 months, please provide that information:Date of last tetanus shot (must be within the last 10 years): Blood type (helpful, but not required): Physician’s Name: Phone Address PERMISSION AND LIABILITY RELEASEI am aware that the mission trip to El Salvador poses risks including but not limited to: sickness, crime, political instability, governmental opposition, personal injury, death, as well as similar and dissimilar risks. I am voluntarily participating in the mission trip with the knowledge of the risks involved. I hereby agree to accept any and all risks of injury or death that may result from my participation in the mission trip. As consideration for being accepted by SHIP to participate in a mission trip to El Salvador during (month & year), as consideration for SHIP assisting in arranging the mission trip, and for other good and valuable consideration the receipt and sufficiency of which is hereby acknowledged, I hereby irrevocably and unconditionally release, waive, discharge, and covenant not to sue or attach the property of Shelter the Homeless International Projects, or any of their affiliates, subsidiaries, divisions, members, directors, officers, employees and agents (collectively referred to as the “Releasees”), for and from all claims of any nature now or hereafter existing whether known or unknown, including but not limited to all liability, on account of death, injury, or damage resulting from the negligence or other acts, however caused, of the Releasees as a result of my participation in the mission trip. I understand that I am giving up my legal rights and the rights of my representatives to recover for injury, death, or property damage. Further, authorization and permission is hereby given to said organization to furnish any necessary transportation, food, and lodging for this participant. The undersigned further hereby agrees to hold harmless and indemnify said Releasees for any liability sustained by said organization as the result of the negligent, willful, or intentional acts of said participant, including expenses incurred attendant thereto. If during the course of this mission trip I or my child-participant should become ill or sustain an injury requiring medical attention, I hereby authorize Ann or Robert Horton or Leon or Noralee Moore (mission trip team leaders) to obtain emergency medical services on my behalf. I will assume financial responsibility for the bills incurred. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself on the one hand, and SHIP and/or their affiliates on the other hand. No oral representations, statements, or inducements apart from this agreement have been made to me. I sign this agreement of my own free will.Date MM slash DD slash YYYY Printed Name of Participant Signature of ApplicantMax. file size: 50 MB.if applicant is under 18 years of age or is still in high schoolDate MM slash DD slash YYYY Printed name of Parent/Legal Guardian Signature of Parent/Legal GuardianMax. file size: 50 MB.