Mission Trip Registration

2024 Brazil | July

A $200 personal donation (NON-REFUNDABLE) is required for all mission trips. This $200 is a tax-deductible donation to the Church Planting and Missions Fund, and will be applied toward your trip fundraising goal. If for some reason the trip you have applied for does not make, or you find that you are unable to go, you can EITHER transfer your donation to another trip or another trip participant, OR simply leave it as a general donation to the Church Planting and Missions Fund.
7/6/2024 - 7/13/2024
$2,400.00
$200.00
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Additional Information

CLEAR CREEK COMMUNITY CHURCH

RELEASE AND WAIVER OF LIABILITY FOR BRAZIL MISSION TRIP 2024:

PLEASE READ CAREFULLY. THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS.

This Release and Waiver of Liability, executed today, for the Brazil Mission Trip 2024 in favor of Clear Creek Community Church (the Church), its Board, Board members, elders, officers, members, attenders, employees, volunteers, and family members herein referred to as “CCCC” is legally binding.

I, the participant OR parent/natural/legal guardian of the below named, understand that I or my child (minor) am requesting to participate in activities on July 6, 2024 through July 13, 2024.  Further, I understand and acknowledge that serious disabilities, illness, death, accidents, and injuries can occur during these activities and for such period said activities may continue.  I also understand that participating in these activities may expose me or my child to activities, conditions, individuals, equipment, or events, which have the potential to cause death, illness, serious injury, and disability.

I, the participant OR parent/natural/legal guardian of the below named acknowledge that I will submit to the governing authorities of the nation to which I am traveling with regard to specific vaccination requirements and Covid-19 testing requirements. I also understand that if I were to test positive for Covid-19 before returning to the United States and be required to remain in the country I have traveled to, all expenses incurred would be my personal responsibility and not the responsibility of Clear Creek Community Church.

I KNOWINGLY RELEASE, INDEMNIFY, HOLD HARMLESS AND DISCHARGE CLEAR CREEK  COMMUNITY CHURCH, its Board, Board members, elders, officers, members, attenders, employees, volunteers, and family members ("RELEASES") FROM ANY AND ALL OF THE ABOVE DESCRIBED ACTIVITIES IN CONNECTION WITH ANY CLAIM ARISING FROM OR IN ANY WAY CONNECTED WITH MY PARTICIPATION IN ACTIVITIES ASSOCIATED WITH CLEAR CREEK COMMUNITY CHURCH  WHENEVER OR HOWEVER THEY OCCUR.

I AGREE TO AND SHALL INDEMNIFY AND HOLD HARMLESS CLEAR CREEK COMMUNITY CHURCH, its Board, Board members, elders, officers, members, attenders, employees, volunteers, and family members FROM ANY AND ALL CLAIMS, LOSSES, DAMAGES, CAUSES OF ACTION, SUITS, AND LIABILITY OF EVERY KIND, INCLUDING ALL EXPENSES OF LITIGATION, COURT COSTS, AND ATTORNEY FEES, FOR INJURY TO OR DEATH OF ANY PERSON, OR DAMAGE TO ANY PROPERTY ARISING OUT OF OR IN CONNECTION WITH THE ABOVE DESCRIBED EVENT/ACTIVITY WHETHER SUCH INJURIES, DEATH OR DAMAGES ARE CAUSED BY THE SOLE NEGLIGENCE, JOINT NEGLIGENCE, OR GROSS NEGLIGENCE OF CLEAR CREEK COMMUNITY CHURCH, its Board, Board members, elders, officers, members, attenders, employees, volunteers, and family members.

THESE PROVISIONS ARE MEANT TO COMPLY WITH THE EXPRESS NEGLIGENCE RULE. I ACKNOWLEDGE THAT THESE PROVISIONS ARE BOLD AND CONSPICUOUS.

*Waiver Consent:
*Digital Signature:
*Do you have a passport?:
*First Name as shown on passport:
*Middle Name as shown on passport:
*Last Name as shown on passport:
Suffix as shown on passport:
*Passport Number:
*Expiration Date:
*Gender:
*Date of Birth (mm/dd/yyyy):
*Social Security Number:
T-shirt size:
*Driver's License Number:
*State Issued:
Alias Name (put N/A if not applicable):
*Emergency Contact Information (Name, Relationship to participant, Cell Phone, Other Phone, Email):
Emergency Contact Information #2:
:
*Health Insurance Provider:
*Policy Number:
*Full Name of the Insured:
What is your blood type?:
:
List any medical restrictions/disabilities that we need to make provision for.:
List medical care received in the last 12 months.:
List any known allergies to medications, food, pollen, etc.:
List history of any major illness or surgery.:
What medicine are you currently taking?:
Are you a member of Clear Creek Community Church?:
How long have you attended Clear Creek Community Church?:
Which Campus do you attend?:
*Are you pregnant?:
If pregnant, how far along?:
:
Who is the Navigator of your CCCC Small Group?:
*Why do you want to GO on a short-term mission trip?:
*How do you want to grow from this trip?:
What short-term mission trips have you been on previously?:
:
*Describe how and when you came to Christ?:
How would you describe your current relationship with Christ?:
*What are your spiritual gifts?:
Do you currently serve in a ministry at Clear Creek? If so, which one(s)?:
Go Trip: Covenant As a member of a CCCC Go Trip, I commit to actively participate and support the whole team to accomplish the goals of our particular project. I recognize by being a part of this team that I am agreeing to the following: PERSONAL COMMITMENT: Growing in my personal relationship with Jesus Christ • As a follower of Jesus, I understand that a commitment to regular times of Bible study and prayer on a consistent basis are important. • I will commit to pray for my leader, our team and our Go Global partner. • I will have my small group and others pray for me before and during the trip. TEAM MEMBER COMMITMENT: Developing an attitude of service and flexibility • I will bring a spirit of flexibility, understanding that plans often change. • I commit to serve my leader, the team, and our Go Global partner in the field. • I will attend ALL meetings and be an active participant in group activities. • I will seek to be sensitive in my words and actions regarding the country’s culture. FINANCIAL COMMITMENT: Practicing relentless stewardship • I acknowledge that others before me have raised funds to help send me and will do my best to help replenish the fund, so others can go after me. • I commit to raise support and/or personally contribute financially to the Church Planting & Missions Fund for the cost of this trip. • I commit to turn in my $200 trip deposit with my Go Trip Application. :
*Digital Signature 1:
I understand that by completing and turning in this application that I am applying to be a member for the above stated mission trip. Completion of this application does not guarantee my acceptance as a member of the mission team for which I am applying. I:
*Digital Signature 2:
*Digital Signature (First, Middle Initial, Last):

Central Office:

999 FM 270, League City, TX 77573 | 281.338.5433