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Mission Trip Participant Form
Please fill out the information below to participate in one of our upcoming Mission Trips.
Step 1 of 2 - Participant Agreement & Liability Form
Cell Phone #
Full Legal Name
As printed on your passport.
Date of Birth
If you do not currently have a valid passport, you are responsible for applying for one immediately. If your trip start date is less than 8 weeks away, you must choose to have your application expedited, at your own personal expense. You must have your passport in-hand no later than 6 weeks prior to the start date of your trip, or earlier, if a visa is required for entry to the country you are visiting. Check with your trip leader to see if a visa is required for travel.
Passport Expiration Date
Passport must have a minimum of 180 days of validity and two blank pages. The last two observation pages do not count as blank pages. Please type the expiration date from your passport as Month/Day/Year (MM/DD/YYYY).
Copy of Passport
Please upload a scanned copy of your passport.
Accepted file types: jpg, gif, png, pdf.
Participant Agreement & Liability Form
Please read through theses terms thoroughly before signing below. A copy of these will be emailed to you for your records.
I AGREE TO THE FOLLOWING TERMS OF THIS TRIP:
• I give permission to Impact Sports to purchase the necessary airfare in my name as listed above. I understand that the airfare for this trip is non-refundable and, once I agree to the trip, I am responsible for the cost of the airfare in full. Impact Sports will be required to pay for the entire cost of the airfare upfront with the understanding that each participant will reimburse the ministry for his/her own ticket and/or any applicable fees. If for any reason whatsoever I am unable to participate on this trip after I have submitted this form and an airline ticket has been purchased in my name, I understand that I am still responsible for the full payment of the airline ticket as well as any other expenses that have been paid on my behalf (i.e., apparel, visa fees, etc.). Once my airline ticket has been canceled, I will be put into contact with Impact Sports’ travel agent to see if transferring the ticket in my name for a future trip is an option.
• I have been made aware of the total trip cost (which includes the airfare referenced above) and acknowledge that I am responsible for paying for the entire trip cost personally, or through donations from family and friends. I agree to use the Sample Support Letter provided to me by Impact Sports to solicit donations and agree to provide each donor with the Mission Trip Donation Form which notifies potential donors that their donations may indicate for me to receive the benefit of their contribution but grants Impact Sports International complete discretion and control over the use of their donated funds to best benefit the Mission Trip. Additionally, both my potential donors and I understand that donations to the ministry are non-refundable. I understand that a deposit in the amount of $500 is due before my airline ticket will be purchased. Please check with your trip leader to find out when your deposit is due. Failure to pay your deposit by the deadline may increase the cost of your airline ticket should prices increase while waiting for your deposit.
• I understand that the goals and purposes of this trip and the overall ministry goal of Impact Sports is to create opportunities to share the Gospel. I acknowledge that this is a mission trip and not a vacation, and that my role on this team will be a part of the overall ministry goals of this specific trip. I understand that the goal of Impact Sports on this project is to share the Gospel with as many people as possible and I agree to do my part to help the team to accomplish its objective.
• I agree to be a representative of Jesus Christ and the ministry of Impact Sports. I understand that Impact Sports and this trip are under the authority of Jesus Christ, and I agree to behave myself in a manner that honors Him. I will not use foul language, drink alcoholic beverages, bring or purchase any tobacco products, view or read anything pornographic or sexually explicit, or participate in any activity that would bring shame to myself, Impact Sports, or the name of Jesus Christ, or would hurt the effectiveness of the ministry of Impact Sports. • I understand that mission work in the countries in which we work is confidential, and I will be careful not to breach security before, during, or after this trip. I will not post on Facebook, Twitter, Instagram, on the Internet, etc. where I will be traveling (name of country), the term ‘mission trip’, any reference to Impact Sports, or the dates I will be gone. I will be careful not to give out specific locations and dates to anyone except my family until after the trip is over. My support letters will state that I will be traveling to the general geographical location rather than naming a specific country. Fundraising websites outside of the one offered by Impact Sports as well as electronic versions of support letters must follow the same guidelines as written support letters but may not name “Impact Sports”. I will not risk Impact Sports’ ability to continue working in restricted areas.
• I acknowledge that with participation in international travel and events comes a potential risk of injury. In consideration of my voluntary participation in an Impact Sports’ mission trip, I hereby release, discharge, and hold harmless Impact Sports, its employees, directors, volunteers, and any other representatives from any claims arising out of or relating to any physical injury that may result to said individual while participating in any Impact Sports’ sponsored event, including any injury by the negligence of any coach or leader while performing his/her duties during the trip. I authorize Impact Sports International and its representatives permission to initiate medical treatment on my behalf as is deemed medically necessary if I become unable to make such decisions for myself.
• I will be in prayer in the months and weeks leading up to this trip and will ask three people from home/church/school to be my prayer partners. I will also commit to spending time in the Bible learning to “give a reason for this hope we have” (materials will be provided to me). I understand that I may be asked to explain my faith, and I commit to doing my best to prepare for that opportunity.
• I will expect and look forward to God doing amazing things in and through me during this trip.
By electronically signing below, you agree to comply with the terms of this trip as stated above in the Participant Agreement & Liability Form and give permission to Impact Sports to purchase an airline ticket in your name.
District of Columbia
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
We'd love to have a photo of you on file for our new database system!
Hispanic or Latino
Black or African American
Native American or American Indian
If student, name of school:
Year in school:
If married, spouse's name:
List sport(s) of expertise:
If played in high school, please list name of school and year graduated:
High School Athlete
High School Coach
If played in college, please list name of school and year graduated:
Describe when you came to know Christ:
Describe previous mission trips:
Home Church (Name, City, and State)
Special Use Gifts:
Doctor's Phone Number
Do you have an active health insurance policy?
The intent of our insurance program is to supplement each trip participant's primary insurance policy so that little to no money is paid out of pocket by our trip participants should an injury occur. Therefore in order to participate in an Impact Sports' trip, participants are required to have an active health insurance policy or they will be required to sign a waiver releasing Impact Sports of any financial obligations related to injuries obtained during the trip.
Health Insurance Co. Name
Health Insurance Phone #
Please list any medical conditions the trip leader should be aware of:
List all current medications.
List all known allergies:
Travel Accident Insurance-Beneficiary Name
For each international mission trip, Impact Sports purchases medical and accidental death insurance for each team member. Please list the name of your beneficiary which is typically a spouse, parent, or sibling.
Relationship to Insured
Contact Phone Number
Terms & Agreement
To the best of my ability, everything in this application is accurate and complete. I understand that I am financially obligated to pay for any portion of the trip that Impact Sports International has to pay on my behalf, even if I become unable to go for any reason. I have read and electronically signed the Participant Agreement & Liability Form and understand my responsibilities before, during, and after this trip. I understand that pictures, video, and audio of me may be used under the discretion of Impact Sports in promotional/video/audio/publications/website and other media without notification. I authorize Impact Sports and its representative(s) permission to initiate medical treatment on my behalf as is deemed medically necessary if I become unable to make such decisions for myself. I understand that there is a certain level or risk involved in traveling internationally and take full responsibility for taking that risk.
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Impact Sports International
P.O. Box 5765
Spartanburg, SC 29304
November 25-27, 2013
Impact Sports Basketball Invitational
at Spartanburg Christian Academy
Copyright @ 2014 Impact Sports. All rights reserved.