Name:
*
First Name
Last Name
Phone Number:
*
Email:
*
Home Address:
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Closest Airport (Airport You Would Fly Out Of):
*
Gender:
*
Select One
Male
Female
Date of Birth:
MM
DD
YYYY
Age:
*
Weight:
Height:
Martial Status:
*
Spouses Name (if married):
Do you have any food allergies or any other allergies we should be aware of?
*
Are you in a relationship with someone going on the trip?
*
Select One
Yes
No
If yes, who?
How did you hear about the trip?
*
Name as it Appears on Passport:
*
Country Issued:
*
Country of Citizenship:
*
Emergency Contact #1:
*
Please put their name, relationship to you, and their phone number in the space below.
Emergency Contact #2:
*
Please put their name, relationship to you, and their phone number in the space below.
Why do you want to go on a trip with Kingdom Kids Homes?
*
Have you been on a missions trip before? If yes, where, for how long, and what organization did you go with?
*
Tell us about your salvation experience or how you came to know the Lord:
*
We would love to hear a little bit about how you came to meet Jesus! If you're not sure no worries, just write not sure!
Do you currently attend church? If yes, where do you go?
*
Do you have medical insurance?
*
Select One
Yes
No
Are you currently taking any medications? (Including over the counter):
*
Select One
Yes
No
If so, please list medications, dosages, and conditions:
PLEASE INDICATE PAST OR PRESENT ILLNESSES OR CONDITIONS:
*
Any Travel Participant going abroad with any preexisting medical problems should carry a letter from the attending physician, describing the medical condition and any prescription medications, including the generic name of prescribed drugs. Any medications being carried overseas should be left in the original containers and be clearly labeled. The Travel Participant should check with the foreign embassy of the country being visited to make sure any required medications are not considered to be illegal narcotics.
If you have none of the conditions listed below, just select "NONE OF THE ABOVE."
Any other notes or things we should be aware about when it comes to your health?
Have you been treated in the last three years for any mental or emotional condition?
*
Select One
Yes
No
Are you currently on any drug for treatment of mental or emotional condition?
*
Select One
Yes
No
If your answer is yes to either of the above, please give a brief explanation and also the name, address, and phone number of your physician or counselor for reference.
To the best of my knowledge, the above medical information is complete and correct.
*
Please place your name in the box below to sign this document.
First Name
Last Name
KINGDOM KIDS HOMES CODE OF CONDUCT:
I will pray for the team leaders and give them my undivided support. I will follow them without criticism or delay. A spirit of unity, care and concern for my teammates, and gentleness will guide my thoughts and actions throughout the trip.
I will adhere to any dress code established for the trip at all times. I understand that dress codes vary widely depending on the local culture and what is considered appropriate attire.
I will not leave the team or the vicinity of our work unless directed or allowed to do so by team leaders.
I agree that contact with members of the opposite sex should be limited and controlled, so that we reflect the light of God and avoid even the appearance of inappropriate behavior. I will not enter the room of a member of the opposite sex at any point during the trip.
I will not participate in activities or visit any establishment or place which may be seen by others as inconsistent with a Christian lifestyle.
I will not use profanity at any time.
I understand that I cannot smoke or consume tobacco products at any time. I will not possess or consume alcoholic beverages or assist others in doing so. I will not possess, use, or distribute any drug or substance for which possession or distribution is unlawful either in the USA or at our destination.
I will abide by any additional guidelines which may be deemed necessary by the team leaders during the event. I will respect the team leaders decisions at all times, even if I do not agree with them.
I will demonstrate Christ-like character and actions to the children, my teammates, and any one else who I may encounter on the missions field.
I will develop and maintain a servant’s attitude toward all nationals and my teammates.
By signing this form, you are agreeing to abide by all the conditions listed above. Any violation of the Kingdom Kids Homes Code of Conduct could result in a team member being sent home at their own expense based on the team leaders discretion.
First Name
Last Name
Todays Date:
*
MM
DD
YYYY
Thank you for applying to be a part of a KKH trip!
We’ve received your application and a KKH team member will be contacting you soon with more details. Be on the lookout for a follow up email from us!
Also, don’t forget to submit your $100 trip deposit if you have not already submitted it! To submit this deposit online, you can go to Ways to Give > Sponsor a Missionary > put your name in the Missionary Name Box > Click Donate > fill out and submit the PayPal form.
Please email us at info@kingdomkidshomes.org if you have any questions.
