ECUADOR ADVENTURE

REGISTRATION

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

Home Church

Are there any diet requirements or health concerns that we should be aware of?

I would be willing to...

Please select all that apply

Lead Worship or Lead a Worship Team

Participate in a Worship Team

Lead a Small Group Discussion

Lead a Team Devotion

Share My Testimony

Lead the VBS Ministry (Plan/Organize in Advance)

Participate in VBS Ministry

Visit and Pray with Families in their Home

Participate in a Construction Project

What is drawing you to this trip? What do you hope to learn from it?

Do you have any fears or concerns regarding this trip?

What excites you most about participating in the Ecuador Adventure trip?

Additional Comments