Thousand Hills Ministry | Ventures that create economic sustainability.

Mission Trip Agreement
  1. This application must be submitted with a $600 deposit 90 days prior to trip to secure your spot, unless your church is coordinating all expenses. Check with your team leader for information.
  3. Please select your trip date(*)
    Please tell us how big is your company.
  5. PERSONAL INFORMATION
  6. First Name(*)
    Please type your first name.
  7. Last Name(*)
    Please type your last name.
  8. Date of Birth(*)
    Please type your date of birth.
  9. Gender(*)
    Please specify your gender.
  10. E-mail(*)
    Invalid email address.
  11. Phone Number(*)
    Please enter you phone number.
  12. Street Address(*)
    Please enter you postal address.
  13. City(*)
    Please enter you city address.
  14. State(*)
    Please enter you state.
  15. Zip Code(*)
    Please enter you zip code.
  16. Please compose a short bio of who you are and why you are going on this trip.
  17. Please compose a short bio of who you are and why you are going on this trip.
  18. Home Church(*)
    Please enter you Home Church.
  19. Pastors Name(*)
    Please enter you Pastor's Name.
  20. Occupation(*)
    Please enter your occupation
  21. Please list your top 3 skills for use on the mission field
  22. Please list your top 3 skills for use on the mission field
  24. PASSPORT INFORMATION
  25. Passport Number(*)
    Please enter you Passport Number
  26. Passport Issuing Country(*)
    Please enter you Passport Issuing Country
  27. Passport Expiration Date(*)
    Please enter you Passport Expiration Date
  29. EMERGENCY CONTACT INFORMATION
  30. Emergency Contact Name(*)
    Please enter your Emergency Contact Name
  31. Relationship to Emergency Contact(*)
    Please enter your Relationship to Emergency Contact
  32. Emergency Contact Cell Phone Number(*)
    Please enter your Emergency Contact number
  33. Emergency Contact Email(*)
    Please enter your Emergency Contact Email
  34. Your Weight (for airline purposes)(*)
    Please enter your weight
  35. Does your Emergency Contact have your medical information?(*)
    Does your Emergency Contact person have all of your pertinent medical information?
  38. MEDICAL INFORMATION
  39. Are you taking Malaria medication?(*)
    Please specify your gender.
  40. Medical Condition - Is there anything you feel we need to know about your medical condition/dietary needs that may impact you on this trip?
  41. Is there anything you feel we need to know about your medical condition/dietary needs that may impact you on this trip?
  43. AGREEMENT
  45. Click here to read the Waiver of Liability and Consent
  46. (*)
    I have read and agree to the Waiver of Liability and Consent
  48. Click here to read the Code of Conduct
  49. (*)
    I have read and agree to the Waiver of Liability and Consent
  51. (*)
    I have read and agree to the Waiver of Liability and Consent
  53. Please type in your
    Full Name as your
    Electronic Signature(*)
    Please enter your Full Name
  54. The balance of your mission trip fee must be paid in advance to the U.S. office at least 45 days prior to your trip date.
  55.