Mission Trip Application

Fields marked with an * are required

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Please make sure to complete all required fields (items marked with an asterisk). After you submit your online registration, you will receive an email confirmation. If you did not receive an email confirmation for your registration, please contact Logan Garabato.

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip / Post Code *

Country *

Gender *

Home Phone

Cell Phone *

Email *

Emergency Contact Information

Name *

Relationship *

Phone *

Email *

Medications

Allergies

Which Mission trip are you wanting to particpate with?

Haiti Outreach Ministries
Tegucigalpa, Honduras - LAMB
Trinidad, Honduras - Building
Trinidad, Honduras - Medical
La Ceiba, Honduras - Habitat for Humanity

First Mission Trip? *

Foreign Language (Specify which language)

Why participate on this trip? *

Concerns & expectations for this trip? *

Deposit info

We ask that all applicants pay a deposit of $250 to secure your spot on the mission trip. Security deposits go toward any pre-paid expenses made by MPPC's deposits to the mission partner. Deposits may be refunded in part or in full only if cancellation by participant occurs prior to the last day to cancel without penalty. Please refer to your trip leader for the specific cancellation date for your trip.

Would you like to pay by Check or Credit Card? *

By signing

By signing, I agree to covenant

Signature *

Date *

I understand and agree to pay a processing fee that is attached to this form *

Total

Mission Trip Application

You are about to contribute...

$260.00

Sunday Service

Mission Trip Application

You are about to contribute...$260.00

Sunday Service

You are about to contribute...

$260.00