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Go-Serve 2024 Mission Trip Registration Form
All mission trip participants must: 1. Be over 18 years of age 2. Be approved for mission participation by a church leader 3. Have an adequate level of English 4. Pay a US$200 refundable deposit with their registration submission 5. Pay for the mission trip one month before the trip commences Please complete this registration form in full. If you are having problems with submitting this form or processing your payment please contact us at ibcm@ibcm.net. Please note that there are a limited number of positions available. We look forward to having you as part of the Go-Serve 2024 mission trips.
The IBCM Network Team
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What you need to complete this mission registration form:
1. Valid Passport (with at least 6 months remaining to expiry date)
2. Credit/Debit Card - to pay your deposit
3. Details of your church leader who will be contacted for your reference.
PERSONAL DETAILS
Title
*
Title
Mr
Mrs
Ms
Miss
Dr
First/Given Name (as on passport)
*
Last/Family (as on passport)
*
Email
*
Email
Confirm Email
Mobile Phone
*
Will be used by IBCM Network staff for mission team contact only.
Country of Residence
*
Select Country
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Date of Birth
*
DD
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MM
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YYYY
2025
2024
2023
2022
2021
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2011
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1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Gender
*
Male
Female
Dietary Requirements
Diabetic
Gluten Intolerant
Lactose Intolerant
Nut Allergy
Vegetarian
Other / Further Details
Further Dietary Information
Do you practice any sports? If yes, please specify
Do you play any musical instrument? If yes, please specify
Please list any health issues we should be aware of
Which languages other than English do you speak?
All participants must be able to speak in English
EMERGENCY CONTACT
Contact Title
*
Title
Mr
Mrs
Ms
Miss
Dr
Contact First/Given Name
*
Contact Last/Family Name
*
Contact Email
*
Email
Confirm Email
Contact Mobile Phone
*
Will be used by IBCM Network staff for mission team contact only.
PASSPORT DETAILS
Passport - Country of Issue
*
Select Country
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep
Chad
Chile
China
Colombia
Comoros
Congo
Congo {Democratic Rep}
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland {Republic}
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea North
Korea South
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar, {Burma}
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
Saint Vincent & the Grenadines
Samoa
San Marino
Sao Tome & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Passport Number
*
Passport - Date of Issue
*
Passport - Expiry Date
*
MISSION EXPERIENCE
Church you attend regularly
*
Mission experience
*
Detail here any previous mission or ministry experience you have.
Name of Church Leader for mission reference
*
Church Leader Email (for reference only)
*
Email
Confirm Email
GO-SERVE 2024 MISSION TRIPS & FEES
All amounts are in US dollars.
Refundable deposit of US$200 is payable now.
Balance of fees are payable one month prior to commencement of the mission trip.
Mission Trip Options (fees are in US dollars)
*
1. Cambodia (1000) 22 June - 02 July 2024
2. Italy (1000) 16-26 July 2024
3. Rwanda (1000) 24 September - 03 October 2024
Please note that an increase in costs may be required if airtravel increases significantly.
Do you need us to purchase Medical Travel Insurance for you?
*
No - I will puchase my own
Yes (50)
Medical Travel Insurance will cost US$50 each.
Would you like to provide mission project assistance in the country you will be visiting?
*
No
(100)
(250)
(500)
Other Amount
Amounts are in US dollars.
Cambodia - gifts will support sponsoring leaders to the national conference.
Italy - gifts will support refugee relief work.
Rwanda - gifts will support the Teens For Christ ministry.
Support Amount ($)
*
Total Mission Cost (US$)
What amount would you like to pay now?
*
Deposit (200)
Full amount
Amounts are in US dollars
Mission Trip Payment (US$)
*
Amounts are in US dollars
Credit/Debit Card
*
Card
Name on Card
For this transaction Stripe, a secure international transfer money agency will be used.
Mission Trip Covenant
As a member of this team I purpose to adhere to the following team covenant:
1. I will serve the overall purpose of the team.
2. I will respect and submit myself to the team leadership.
3. I will preserve and protect the unity of the team.
4. I will use complete discretion when relating to members of the opposite sex.
5. I will respect the local culture and avoid public criticism of their way of life.
6. I will give 100% of my energy to the team when in the country.
7. I will not pursue any personal interests during the mission trip.
8. I will be punctual to all team events unless excused by a team leader.
9. I will strive to be a person of integrity in all my actions and attitudes.
10. If at any time while on mission my behaviour constitutes a problem, the team leader has the authority to ask me to return home. Any additional costs incurred, as a result of this action will be at my expense.
Disclaimer
I declare that I am a member or associate of a Christian Brethren church or organisation. I understand that by submitting this form I confirm that the information given on this booking form is accurate and that I recognize that it is necessary for IBCM Network to hold and process the personal data provided for the purposes of the Go-Serve 2024 mission trips only, and to communicate with me about it.
I also undertake to ensure that:
1. I have my own medical insurance.
2. I meet the visa requirements of the mission country.
3. I agree to abide by the Go-Serve mission trip team covenant.
4. I will pay the balance of the Go-Serve mission trip by one month prior to its commencement.
5. I will book and pay for my own flights to the mission trip destination.
I will not hold the leaders of the Go-Serve mission trip responsible for any accident or loss incurred on my part.
Disclaimer
*
I Agree to the Covenant and the Disclaimer
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