Trip Participant Understanding *

• Our SCF Spring Break Medical Mission Trip is OPEN TO EVERYONE regardless of religious affiliation or none. • We understand that not everyone is Christian. While all participants will be expected to attend all large group gatherings that include singing, bible study & prayer, please don't feel obligated to sing or pray. Our goal is to cultivate honest discussion with both our skeptical and believing friends as we investigate and reflect upon the person of Jesus. • Since we are a Christian organization and our faith naturally follows us into the healthcare setting, in addition to offering quality healthcare, we will also offer spiritual support to those patients who request it. Students have the opportunity to pray with their patients if they desire to do so. • It is important for everyone to understand, that we do NOT believe that religion or faith is a prerequisite or condition to receiving healthcare. We will not allow our faith to be an obstacle to anyone feeling welcome to be treated. We intend to see every patient with the exact same level of care and attention regardless of their interest in Christianity.

Yes, I Understand

Contact No. *

(###)

###

####

DOB *

MM

DD

YYYY

Classification *

MS-1

MS-2

MS-3

MS-4

Intern/Resident

Health Professions Student*

Physician

Staff

Other/Non-Medical

Emergency Contact Cell# *

(###)

###

####

Religious Affiliation *

* Our medical mission trip is OPEN to everyone, regardless of religious preference.

Christian-Protestant

Catholic

Hindu

Muslim

Buddhism

None

Other

Are you willing to be a van driver?

Must be at least 25 Years old

Yes

No