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Lastleaf
Missions Trip Registration 2024
Thank you for your interest in our 2024 Lastleaf Missions Trip to Armagh, Northern Ireland
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First Name
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Last Name
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Email
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Phone
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Birthday
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Emergency Contact
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Emergency Phone
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Your T-Shirt Size
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XS
S
M
L
XL
2XL
3XL
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Do you have past missions trip experience?
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YES
NO
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Where do you attend church? Please supply the name and address:
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Church involvement: What church ministries are you currently involved in?
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Please list any community or outreach volunteering you've done in the past 2 years:
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Testimony: briefly write your testimony or faith journey here:
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Leadership experience: Please list any leadership experience you've had in the past 2 years:
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Talents and Interests: please list any current extra curricular activites you enjoy or are involved in (ie. music, sports, drama, art etc.):
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Physician's name and phone number:
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Medical History: List any serious injuries (with dates):
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List chronic or recurring illnesses:
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List any allergies you have:
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List any allergies you have to insect stings or medications:
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List any special diet restrictions you have:
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List any medications you are currently taking (or may have need to take ie. epi pen):
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List any activity restrictions you have:
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Do you have any breathing issues (ie. asthma, sleep apnea etc.):
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Is there anything you need to tell us about your health?
Deposit of $125 USD or $175 USD for a family is due with application
Are you registering as an Individual, Group, or Family?
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Individual
Group
Family
If Group or Family, are any members minors?
Select...
No I've registered as an individual
Yes I am a minor
Yes
No
If you or anyone in your group or family is a minor, you will need to fill out the Minor Consent Trip Application form (one form per person). I acknowledge the Minor Consent Form and will upload it below:
Trip Application
Interest Form
Trip Dates: July 12-22, 2024
Downloads
Minor Consent Trip Application
Payment Terms and Conditions
Lastleaf Waiver
