Mission Lakota Team Application

This application is specifically for those applying to be on our 5+5 Mission Lakota Team. ***Please note: Do not purchase airfare or book hotel room/s for any upcoming missions with Lakota. This application process is first required and needs approval.

First Name

Last Name

Mobile Phone

Give your consent to receive SMS messages by simply checking the box.

Birthdate

/ /

Gender

Male Female

Address

Marital Status

Are you a U.S. Citizen?

Yes No

Background Information

As part of our commitment to ensuring a safe and secure environment for all participants and communities involved in our 5+5 mission trips, we require all participants to undergo a background check. This helps us maintain a high standard of safety, trust, and integrity. The background check will be handled in accordance with applicable laws and regulations and will be used exclusively for the purpose of evaluating your suitability for participation in the mission trip.

Do you have an active background check on file with CCC?

Yes No

Emergency Contact Information

First & Last Name

Relationship

Phone Number

First & Last Name (optional)

Relationship (optional)

Phone Number (optional)

Medical Information (in case of an emergency, we may need to provide the following information)

Colorado Community Church Involvement

Is CCC your church home?

Yes No

Do you participate at CCC? (Bible Study, CCC Activities, etc.)

Yes No

Do you volunteer at CCC?

No Yes

Please describe your relationship with Jesus Christ. How did you come into relationship with Him and how does your relationship with Him remain vibrant and growing?

5+5 Mission Team Information

Travel & Lodging Information

Individuals participating in our 5+5 Mission Lakota are responsible for their own transportation to and from the mission location, as well as their own lodging.

Yes - I understand.

What form of transportation will you use to participate in the mission trip?

Vehicle RV Train Airplane Other

Fundraising Responsibility & Disclaimer

Colorado Community Church gives each participant the opportunity to raise funds through our website platform, using preference donations to cover their individual contribution. Any funds donated to your individual goal, is to be used for the current 5+5 Mission Trip only. If you are unable to participate in the 5+5 Mission Trip at any point, all funds donated will be redirected to the general mission team fund to be used at the time of the current mission. Therefore, funds donated to your individual account are non transferable. The funds donated may not be used for any other 5+5 Mission Trip. By checking the box, you understand that the funds raised, will solely be used for the current 5+5 Mission Trip you are applying for.

Yes - I understand.

Mission Trip Meetings

There will be several meetings prior to the mission trip. Each team will have their own mandatory team planning meetings and attendance is crucial to the success of the mission trip. We encourage you to add all dates provided by the team leader to your calendar immediately. By checking the box, you understand that you are required to attend these meetings so that you may be prepared for the mission ahead.

Yes I understand.

Waiver, Release, Covenant & Code of Conduct

To participate in a 5+5 Mission Trip, you must complete our Medical Release & Physical Health Form, Media Waiver & Release Form, Travel Disclaimer & Release, Financial Commitment Form, Team Covenant & Code of Conduct Forms. These forms are to follow.

Yes - I understand that to complete this application I must acknowledge and sign all waivers/releases & forms.

Please submit below to complete the first portion of the Colorado Community Church 5+5 Mission Team application. After clicking "SUBMIT", you will be immediately redirected to complete your waivers. Do NOT refresh your browser or exit the application before completing ALL waivers. Doing so may cause you to need to submit your application again. There are FIVE waivers for you to e-sign. You will see a green confirmation box after all waivers have been completed; you will receive copies via email of your signed documents.

***All information obtained in this application is to remain confidential and will only be shared with our Pastor of Outreach, Community Involvement Administrative Assistant and the 5+5 Mission Leader/s.

Submit

Form Entry

Background Information

Emergency Contact Information

Medical Information (in case of an emergency, we may need to provide the following information)

Colorado Community Church Involvement

5+5 Mission Team Information

Travel & Lodging Information

Fundraising Responsibility & Disclaimer

Mission Trip Meetings

Waiver, Release, Covenant & Code of Conduct

Colorado Community Church is an interdenominational, multi-cultural church located in Aurora, Colorado. We exist to transform our city and beyond by connecting people to Christ, Community, & Calling!

Saturday Service
5:00pm

Sunday Services
9:00am & 10:45am*
*Live ASL interpretation

info@coloradocommunity.org
(303) 783-3838
14000 E. Jewell Ave. Aurora, CO 80012

Form Entry

Background Information

Emergency Contact Information

Medical Information (in case of an emergency, we may need to provide the following information)

Colorado Community Church Involvement

5+5 Mission Team Information

Travel & Lodging Information

Fundraising Responsibility & Disclaimer

Mission Trip Meetings

Waiver, Release, Covenant & Code of Conduct

Colorado Community Church is an interdenominational, multi-cultural church located in Aurora, Colorado. We exist to transform our city and beyond by connecting people to Christ, Community, & Calling!

Saturday Service5:00pmSunday Services9:00am & 10:45am**Live ASL interpretation

info@coloradocommunity.org(303) 783-383814000 E. Jewell Ave. Aurora, CO 80012

Saturday Service
5:00pm

Sunday Services
9:00am & 10:45am*
*Live ASL interpretation

info@coloradocommunity.org
(303) 783-3838
14000 E. Jewell Ave. Aurora, CO 80012