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Home
About
What We Do
Prayer Requests
Get Involved
PhotoGallery
Shop
- Products
- Cart
Give
Contact

Application Form

Faith in Action Missions Application Form

Please fill out this form and we will get in touch with you shortly.

I am applying for*
Group Name*
Are You a Minor?*
- Yes
- No
If you are a minor (under the age of 18), your parent or legal guardian must fill out and sign this agreement on your behalf.
Would you like to receive our quarterly e-newsletter?*
- Yes
- No
Personal Information
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Mobile Phone
Email
Date of Birth
Date Format: MM slash DD slash YYYY
Place of Birth
Citizenship*
Passport Number
Passport Expiration Date
Date Format: MM slash DD slash YYYY
Marital Status
Emergency Contact #1
Name
First Last
Home Phone
Mobile Phone
Email
Relationship to You
Emergency Contact #2
Name
First Last
Home Phone
Mobile Phone
Email
Relationship to You
Pastoral Reference
Name
First Last
Phone
Email
Relationship to You
Personal Reference #1
Name
First Last
Phone
Email
Relationship to You
Personal Reference #2
Name
First Last
Phone
Email
Relationship to You
Financial
How will you raise the financial support required for InterAct?
Spiritual Background
How did you become a Christian?
What does it mean to be born again?
Describe yourself as a person. What are your strengths and weaknesses?
What is your goal for your upcoming missions involvement and what do you expect to learn?
What position and involvement do you have, or have you had, in Christian service?
Please describe any significant changes in your life in the past 2 years
Please list any previous missions involvement
Skills
Please describe any special skills you may have (carpentry, electrical, medical, cooking, teaching, etc)
Please list any languages you speak and describe your fluency level (converstaional, fluent, native speaker)
Medical Information
As an applicant you are responsible for contacting your primary care physician and/or public health nurse regarding medical precautions/immunizations required for travel in Guatemala. Any personal prescriptions or over-the-counter medications must be taken in the original containers.
Primary Physician Name
First Last
Primary Physician Phone
Have you had any major illness during the past two years?
- Yes
- No
If yes, please explain
Do you take any medication regularly?
- Yes
- No
If yes, please explain
Do you have any special dietary concerns (food allergies, diabetic, etc)?
- Yes
- No
If Yes, please explain
Please describe any other medical conditions you have that might need special attention
Are you up to date with vaccinations/immunizations?
- Yes
- No
Are you willing to take vaccinations/immunizations required for travel?
- Yes
- No
How would you rate your overall physical condition?
- Excellent
- Good
- Average
- Fair
- Poor
Do you have any physical problems that would hinder your activity?
- Yes
- No
If Yes, please explain
Commitments
If I am accepted by Faith in Action, then...*
- I commit to follow the directives of Faith in Action leaders and local pastors in a willing and cooperative manner
- I commit to put Christ first and set aside my own personal agendas in order to reach the team objectives
- I commit to abide by the Faith in Action Code of Conduct
View Code of Conduct
Medical Consent Agreement
Medical Consent Agreement Acceptance
- I DO accept the "Medical Consent Agreement" below
- I DO NOT the "Medical Consent Agreement" below
In the event of a medical emergency I/we hereby give permission to Faith in Action or their designate to secure appropriate medical treatment which may include hospitalization, anesthesia, and/or surgery for the applicant.

If I/we purchase a limited group medical insurance policy this policy may provide reasonable insurance coverage. However in case of an emergency return to your home country, a policy deductible, over the policy maximum medical expenses, may require you to cover added expenses if it does not qualify under the purchased insurance policy. I hereby waive, discharge claims, and release from liability Faith in Action, from any such claim. I agree to assume full financial responsibility in case of accidents resulting in injury, illness or death.
Medical Insurance Policy #
Group ID #
Insurance Provider
Release of Liability
This form is an acknowledgment of short/long term foreign outing Responsibility, Express Assumption of Risk, and a Release of Liability.
Release of Liability Acceptance
- I DO accept the "Release of Liability Agreement" below
- I DO NOT accept the "Release of Liability Agreement" below
This form is an acknowledgment of short/long term foreign outing Responsibility, Express Assumption of Risk, and a Release of Liability.

I understand that during my participation in Faith In Action ministries and foreign outreaches, I may be exposed to a variety of hazards and risks, foreseen or unforeseen, which are inherent in each outing experience and cannot be eliminated without destroying the unique character of the ministry. These inherent risks include, but are not limited to, the dangers of serious personal injury, property damage, and death ("Injuries and Damages") from exposure to the hazards of travel and living in Guatemala. Faith In Action and the field mission directors have not tried to contradict or minimize my understanding of these risks. I know that Injuries and damages can occur by natural causes or activities of other persons, animals, trip members, trip leaders, assistants, and/ or third parties, either as a result of negligence or because of other reasons. I understand that risks of such injuries and damages are involved in adventure travel such as ministry outreaches and I appreciate that I may have to exercise extra care for my own person and for others around me in the face of such hazards. I further understand that on any outing there may not be rescue or medical facilities or expertise necessary to deal with the injuries and damages to which I may be exposed or incur.

In consideration for my acceptance as a participant on any outing, and the services and amenities to be provided by the ministry in Guatemala in connection with the outing, I confirm my understanding that:

I have read any rules and conditions applicable to the outing made available to me; I will pay any costs or fees for the outing or accorded during the outing; and I acknowledge my participation is at the discretion of the group leader.

I understand that I am personally responsible for all risks associated with this travel both medically and financially. This also applies to any incident resulting from transportation provided by Faith In Action in Guatemala during any outing. I agree to assume full financial responsibility in case of accidents resulting in injury, illness or death.

This Agreement is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this agreement is held to be invalid or legally unenforceable for any reason, the remainder of this agreement shall not be affected thereby and shall remain valid and fully enforceable.

To the fullest extent allowed by law, I agree to WAIvE, DISCHARGE CLAIMS, AND RELEASE FROM LIABILITY Faith In Action minis- tries, its officers, directors, employees, agents, and leaders from any and all liability on account of, or in any way resulting from Injuries and Damages, even if caused by negligence of Faith In Action or its officers, directors, employees, agents, and lead- ers, in any way connected with this outing. I further agree to HOLD HARMLESS Faith In Action, its officers, directors, employees, agents, and leaders from any claims, damages, injuries or losses caused by my own negligence while a participant on any outing. I understand and intend that this assumption of risk and release is binding upon my heirs, executors, administrators and assigns, and includes any minors accompanying me on any outing.

I have read this document in its entirety and I freely and voluntarily assume all risks of such Injuries and Damages and notwithstanding such risks, I agree to participate in this ministry as either a long term helper or a short term visitor.
Application Signature
Application Agreement
- By signing my name below, I hereby AGREE that my typed name constitutes the acceptance of the "Commitments", the "Medical Consent", "Code of Conduct" and the "Release of Liability" sections of this form.
Applicant Name*
Typing your name constitutes your legally binding signature.
Applicant Parent/Guardian Name*
As parent or legal guardian, I hereby agree and consent to the foregoing agreement on behalf of the minor listed above. Typing your name constitutes your legally binding signature.
Date
Date Format: MM slash DD slash YYYY

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Faith in Action is a Christian missions organization focused on reaching some of the poorest and most remote communities in Guatemala with the Gospel of Jesus Christ.