Partnership Visit Application

Sun 14 Oct 2018

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Please submit your $250 deposit via pushpay here (note your name in the comments field): https://pushpay.com/g/providencewc?f%...

ou may also mail your deposit check to:

International Ministry Director: Melinda Snow
Providence Church
PO Box 663
West Chester, PA 19381

Contact information

Booking details

Who’s this registration for?

Personal Information

Please enter all information as it appears on your passport

Emergency Contact Information

Church Information

Health Information

Additional Information

Criminal Background Check

I authorize Providence Church to conduct a criminal background check (if needed) with the information I have provided. Note: failure to check "Yes" will result in your application being denied for acceptance.

Legal Guardian Information

If applicant if under the age of 18

Ministry Experience and Personal Testimony

Character References

Cannot be a relative

Pre and Post Trip Meetings

Pre and Post trip meetings: We will be meeting together as a team approximately 8 times before our time in-country and 2 times post-trip to learn in-depth about how to engage in healthy property alleviation both abroad and at home. We will be using Helping Without Hurting in Short-Term Missions as our guide. I understand that these meetings are mandatory and a very important part of the entire experience.

Release/Disclaimer of Liability

In consideration of the benefits derived from my participation in this missions trip with Providence Church, I do hereby voluntarily release, acquit, and forever discharge the church and its directors, officers, employees, and agents from all manner of suits, actions, claims, demands, and liabilities which may arise from my participation in the trip. 

I recognize that the conditions in some of the places to which I travel are not the same standards as the conditions to which I am accustomed (I.e., political environments and judicial systems). I realize further that there are certain health and detainment risks as well as other risks to my property and me, and I enter into participation in this trip with knowledge of those risks.

I understand that this document constitutes a full and complete waiver of all possible claims, including claims for negligence in personal injury or property damage, arising out of my participation on this trip.

No provision of this document shall, in any way, limit my right to make claims against persons other than the church, its director, officers, employees, and agents.

I understand that by signing this release/disclaimer that I am bound to the contents therein.

Copy of Passport

Upload a scan of your passport here, if you have it. You may also mail a copy of your passport to ATTN: International Ministry Director: Melinda Snow Providence Church, PO Box 663 West Chester, Pa 19381.

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Images, PDFs, text files, Microsoft Office, Apple Productivity and OpenOffice documents are all supported for upload.

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