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Group Member INFO
Please fill this out in it's entirety:
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Name, Age, Gender, T-shirt Size (of all members)
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I understand as a group leader, that any team members under the age of 18 must have a legal guardian's permission to attend this trip with Impact PCG Student Ministries. I agree that I will obtain the proper permission for all team members wherein it applies. *
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Are there any current moral issues or physical conditions that could affect anyone's involvement on this Mission Trip? *
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LODGING QUESTION:
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We are happy to provide lodging for Saturday night at the host hotel (located in Pulaski, VA) if you would like to stay over. Some groups prefer to head home after the event ends on Saturday (approximately 2 PM). *
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Choose service time: *
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AUTHORIZATION:
I have read and understand the above information. The information I have given Impact Student Ministries is accurate and true to the best of my knowledge. I also give Impact PCG Student Ministries the right to use my (and all team members listed on this application) picture, voice and/or testimony in any form of promotional materials. My enclosed signature signifies my approval of all limitations listed above.
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I understand this is a legal representation of my signature.
Clear
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APPLICATION FEE PAYMENT ($50 per person)
(Your non-refundable application fee is required before your application can be processed. Your remaining balance will be due by the start of the trip.)
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