Student Life Mission Trip 2020 - Registration Form

    Deadline to register is January 12th or when available spaces have been filled (whichever comes first).
    • MISSION TRIP PARTICIPANT INFO
    • First Name
      Last Name
    • PARENT INFO
    • First Name
      Last Name
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    • ADULT VOLUNTEERS - The mission trip cannot happen without our awesome adult volunteers. The number of students we can take is limited by the number and gender of adult volunteers and drivers. Please consider joining us and sharing this experience with your child and the rest of our wonderful youth. We promise you will be blessed!
    • First Name
      Last Name
    • EMERGENCY CONTACT INFO
    • First Name
      Last Name
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    • SPECIAL DIETARY NEEDS FOR PARTICIPANT?
    • PARENT AGREEMENT
    • By submitting this form I agree that my son/daughter has permission to participate with LUMC Youth in the Student Life Mission Camp at Liberty University in Lynchburg on July 13th-17th, 2020. I will turn in a check for the non-refundable $70 deposit (payable to LUMC Youth) to reserve his/her spot and understand that his/her space is not reserved until that deposit is received in the church office. I have read the trip info sheet and understand that the remaining balance of $300 is due no later than June 7th. If I have not already done so, I will complete a 2019-2020 "Parental Consent, Medical Emergency & Liability Release Form" for my child. I will also have my child complete and turn in the Mission Trip application form and Code of Conduct form, all of which can be found on the LUMC Youth website (www.lumcvb.org).