Mission Trip Registration

Kentucky Oct 21-25

10/21/2019 - 10/25/2019

Additional Information

*Full Legal Name:
*Date of Birth:
Mailing Address (if different from above):
Cell Phone # (if different from above):
If available, would you like to use miles to purchase your airline ticket and cut down on the cost of your trip?
Sky Miles #:
American Air #:
For travel insurance purposes:
Name of Beneficiary
Relationship to Beneficiary
*What type of short-term mission experience do you have? 
Do you sing?:
If yes, would you be willing to lead worship for the team during the trip?:

Please share any special skills or abilities you could use during this missionary trip.                  (i.e.: Puppets, Drama, Guitar, etc.)  

*Are you a member of Hebron Church?:

If so, in what areas do you SERVE IN [CARE, celebrate recovery, Greet Team, Choir, etc.]? 

*Are you in a Connect Group?:
If Yes, Who is your connect group leader(s):
If Hebron is not your church home, what church do you attend?:

Please provide one pastor reference and one family/friend reference:

*Pastor's Name:
*Pastor Phone Number:
*Friend/Family Name:
*Friend/Family Phone Number:
*Have you personally placed your faith in Jesus?:

If so, briefly share what your life was like before Christ, what led you to accepting Christ, and how Christ has changed your life:

*Why do you want to go on this Mission Trip?:
*How are you currently growing in your relationship with Christ?:
*How are you currently sharing your faith? What is a recent example of this?:
*Why should Christians be involved in Missions (locally, nationally and internationally?):