MISSION QUEST / GLOBAL QUEST - SUMMER TRIP APPLICATION
1) Name (as written on birth certificate): 2) Social Security Number: 3) Male: Female:
4) Permanent Address: City: State: Zip:
5) Daytime Phone: 6) Evening Phone:
7) Birth Date: 8) Age: 9) Height: 10) Weight:
11) Father's Name: 12) Daytime Phone:
13) Mother's Name: 14) Daytime Phone:
15) Legal Guardian's Name: 16) Daytime Phone:
17) Date of Salvation 18) If you are in a dating relationship is this person going on a Mission Quest trip?(Y,N)
19) If yes to #18, Name of Participant:
20) Have you ever been overseas?(Y,N) 21) If yes, with what organization(s)?
22) Have you ever: Been expelled from school?(Y,N) 23) Been in a juvenile facility?(Y,N)
24) If yes, please explain:
25) Church Name: 26) Pastor's Name:
27) Church Address: 28) Church Phone:
29) How long have you been involved there? 30) How are you involved?
31) What sources influenced you to join a MQ/GQ team?
32) Are your parents in agreement with your decision? 33) Do you have ANY physical limitations?
34) Have you ever undergone psychiatric treatment? 35) If yes, when?
PLEASE READ CAREFULLY BEFORE SIGNING
Mission Quest/Global Quest is a highly disciplined organization with regulations in many areas including dress, conduct and Christian lifestyle. These are
explained in the information packet sent to accepted applicants. Team members and leaders adhere strictly to MQ/GQ policies and are subject to dismissal for
disobedience without refund or reimbursement. Team members and leaders serve at their own risk and MQ is not liable for any injury, damage or loss which
may be sustained during the applicant's involvement with MQ/GQ.
All funds contributed toward the trip are non-refundable and tax deductible. All participants must show proof of health insurance coverage. MQ/GQ trips include
intense physical activity including extended hiking, continuous walking and strenuous choreography. We require all participants to be in good physical condition
and may require a physical examination and reference from a doctor.
The information I have given Mission Quest/Global Quest is accurate and true to the best of my knowledge. I also give MQ/GQ the right to use my picture, voice
and/or testimony in any type of promotional or advertising materials. My enclosed signature (and the signature of my parent or guardian if I am under 18)
signifies my approval of all limitations listed above.
Your Signature Date:
Parent's Signature: Date: