IMPAC Missions Trip

IMPAC Missions Trip - Minor

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IMPAC is a ministry of Artists in Christian Testimony Intl (A.C.T. Intl)

A.C.T. Intl exists to mobilize & equip innovative Christians
for church, missions and market place ministry world wide.

Through IMPAC, Christians involved in performing arts, visual arts, sports, technology, medicine and other professional careers; travel to economically depressed communities across the world to share the love of Christ - using their gifts and talents as tools to host evangelism outreaches, and address the social and economic needs of families. IMPAC aims to see the salvation of souls, eradication of poverty, correction of maladaptive behaviors and repair of defective social values.

Application Instructions

As a team member on an IMPAC missions project, you are a temporary staff person of A.C.T. Intl. This application provides the information needed by the IMPAC leadership to evaluate your fit for this project and by A.C.T. Intl to approve your status as a short-term staff person.
A nonrefundable deposit of $150 is required with this application.
You may save your work, creating a password that will be emailed to you, which will allow you to log in to complete the application at a later time.
Upload fields are provided within the application to send requested documents. There is a 20 MB limit for the total size of all uploaded files in this form, so attempt to reduce the size of your uploads as much as possible, or email the documents to Judie@ACTinternational.org.

Application Deadline for Upcoming Missions Trip is May 1, 2023.

All minors (under the age of 18) must have a parent or legal guardian sign the RELEASE AND WAIVER AGREEMENT and the POLICY AGAINST SEXUAL HARASSMENT on behalf of the Minor.

Minors under the age of 16 years old must be accompanied by parent(s), a legal guardian, or an adult who is an immediate member of the family who is at least 21 yrs old.

Minor applicant(s) under the age of 18 years old must complete and submit this application.

The adult(s) participating in this trip with the minor(s) who are under the age of 16 must complete and submit the following application - https://www.tfaforms.com/4976471.

Application Deadline is May 1, 2023.

We highly recommend that you save your progress so that you can return to the application to complete it at a later time.

Page 2

Make sure you are completing the correct application

Submit this application if you are under the age of 18.

If you are either of the following, submit this application instead - https://www.tfaforms.com/4976471

You are at least 19 yrs old
You are a parent, guardian, or immediate family member at least 21 yrs old accompanying a minor under the age of 16

Application Deadline is May 1, 2023.

Have you been on a another IMPAC Trip?

No - this is my first IMPAC TripYes - I have been on another IMPAC Trip

For which IMPAC trip are you applying?

Trinidad - July 22-29, 2023

On the date of this trip:

I will be 15 to 17 years oldI will be under 15 years old

First Name:

Last Name:

Preferred/Nickname:

Gender:

MaleFemale

Applicant's Birth date

Minors under the age of 15 years old must be accompanied by parent(s), a legal guardian, or an adult who is an immediate member of the family who is at least 21 yrs old.

Name of the adult accompanying you on the trip

What is your relationship to the adult who is accompanying you on this trip?

Contact Details

Email Address:

Primary Phone Number:

Include country code if outside the USA

Other Phone Number:

Include country code if outside the USA

Postal Address:

Physical Address (if different)

City / Town:

State / Province:

Postal Code:

A.C.T. Intl is an Equal Opportunity organization.
Discrimination on the basis of race, color, sex, national origin, age or disability is prohibited.
Because A.C.T. Intl is a religious organization, it exercises those rights afforded to religious organizations, which allow the use of religious qualifications and tenets
in volunteer and employed staff actions.

Background checks Required.

Save your Progress

Use the link at the top or bottom of this form to save your progress.

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YOUR CHRISTIAN TESTIMONY

Describe the circumstances and experience of you surrendering your life to the Lord.

How long have you had a relationship with the Lord?

Church Name

In what countries have you been to for short-term missions trip(s)?:

Please describe short-term mission experience(s) and how you were impacted.

List any languages you know (other than English) and level of proficiency:

List any special talents or skills you believe would benefit the team and this trip?

What concerns or questions do you have about this trip?

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Do you have a current Passport?

YesNo

Your Passport Information

Passport Number

Date of issue

Date of expiration

Country of issue

Place of Birth

Upload a copy of your passport or your passport application

IMPAC Missions Trip Team Policies

Indicate your commitment to the IMPAC trip polices by checking the box by each policy and with your signature.

As a representative of Jesus Christ, my home country, and IMPAC, I will behave at all times in a manner that brings glory and honor to these institutions. I will respect and follow the decisions of IMPAC.I am aware that my every word and action are being watched during the entire missions trip experience. Therefore, I agree to act and talk in a manner that glorifies the name of Jesus Christ. I want everything I do or say to draw people to Jesus. I will be spiritually, physically, and mentally prepared for a mission trip that will stretch me and mold me in ways that I can only imagine.As a guest in the country I am visiting, I will respect and follow the traditions of the local people and nationals. For example: if the way I dress offends them, I will change. I will go to learn from the people I am visiting. I will not criticize the culture, efficiency, work habits, food, or traditions of the country. I also will not talk negatively about my country’s politics or the host country’s politics during the trip.I will not go to judge, but to learn, and to share the person of Jesus through my words, actions, and deeds. I agree to have a servant attitude at all times. When I am doing a task or ministry I don’t particularly care for, I will try my best and be a witness in this activity. I will use words that encourage and build up my team members and the nationals at all times. This means I will refrain from gossip or words that bring dissention and take focus away from the goals of the trip. I will have a positive attitude at all times. Every trip has its challenges and unforeseen circumstances. People could get sick, items lost, and plans changed. I realize that there are times I will need to adjust my expectations and plans and look at challenges as opportunities to be a witness for Jesus Christ. I will work with all members of the team. I will refrain from pursuing romantic relationships during the trip. If my spouse or significant other is on the trip with me, I will make every effort to spend time with each person of the group and interact with all team members. I realize that sleeping accommodations most likely will not allow me to stay in the same room as my spouse. Men will be in rooms with men, and women with women. Rooms will have 3-4 people per room. I will attend all team meetings and fulfill the responsibilities I have agreed to before, during, and after the trip. If I am not able to attend a meeting I will be in contact with IMPAC to discover what I have missed. I will abstain from using or consuming alcohol, tobacco products, and illegal drugs while on the trip. I will not steal or commit illegal acts while on the trip. If in the future I desire to return on another missions trip to the country I’m now scheduling to visit with IMPAC, and wish to visit any connections or ministry locations from this trip, I must do so through IMPAC or receive IMPAC’s written permission to do so. This will enable the overall vision and plans for the ministry as agreed upon through IMPAC’s connections in the country, to continue. I will follow the travel, clothing, financial, and medical guidelines set forth and explained to me prior to the trip. I am responsible for knowing and following everything explained at the team meetings. I will follow all import and export laws. I will not attempt to bring any items or goods into the host country or back into my country that is banned. If I break any of the rules listed above, at the discretion of an IMPAC representative and in conjunction with my group leader, my missions trip can be terminated and I can be sent home at my own expense. I realize that to attend this trip and represent Jesus Christ on the mission field is a privilege and if I abuse that privilege this constitutes the right for my trip to end prematurely.I understand that as part of this application there is a $50/person nonrefundable deposit.I understand I am responsible for all costs incurred with this trip, including the airline ticket, trip insurance, and on the ground expenses.

DIGITAL SIGNATURE of MINOR and PARENT or LEGAL GUARDIAN of minor

I have read and understand Team policies.

Full Legal Name of Minor:	Full Legal Name of Parent or Legal Guardian:
Date:

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All minors (under the age of 18) must have a parent or legal guardian sign the RELEASE AND WAIVER AGREEMENT and the POLICY AGAINST SEXUAL HARASSMENT on behalf of the Minor.

A.C.T. INTL RELEASE AND WAIVER AGREEMENT FOR ONE WEEK MISSIONS TRIP

WARNING: THIS DOCUMENT IS AN AGREEMENT WITH LEGAL CONSEQUENCES AND SHOULD BE REVIEWED BY AN ATTORNEY AS IT MEMORIALIZES A COMPLETE WAIVER AND RELEASE OF POTENTIAL CLAIMS THAT MAY ARISE AND INURE TO YOUR BENEFIT. IT SHOULD BE COMPLETED BY EACH PARTICIPANT PRIOR TO PARTICIPATING IN THE ONE WEEK MISSION TRIP. (

All minors must have a parent or legal guardian sign the RELEASE AND WAIVER AGREEMENT and the POLICY AGAINST SEXUAL HARASSMENT on behalf of the Minor.

In consideration of my participation in the Event, I make and guaranty the following representations:

I have read and understand the Event description, application and participate requirements. I agree to comply with the expectations communicated in these documents, and I understand that certain behavior is required of me as consideration to participate in the Event, including, but not limited to refraining from smoking, vaping, or otherwise consuming any drug or chemical for which I do not have a current prescription, drinking alcohol, consuming tobacco in any form, sexual activity, and use of inappropriate language. Prescribed medical marijuana is not permitted without express written permission of A.C.T. Intl.
As the Event will take place in a location with which I may be unfamiliar with local customs and practices and I am participating in an event sponsored by A.C.T. Intl., I will obey instructions given by A.C.T. Intl. through appointed leaders at the Event at the time such instructions are given.
If I am under fifteen years of age, my parent or legal guardian or an adult who is an immediate member of the family who is at least 21 yrs old must accompany at the Event.
I am in good health and, prior to my participation in the Event, I will consult my medical provider and will have received travel vaccines required and recommended by the Center for Disease Control and any applicable state or local authority for travel in the countries in which I may travel for purposes of my participation in the Event. Further, I have consulted my doctor and my doctor has cleared me for and I am prepared for travel with any medical condition that I may have.
I understand the dangers and risks inherent with the travel required for participation in the Event. Those dangers and risks include, but are not limited to, (1) hazards of travel by air, boat, raft, jeep, automobile, bus, taxi, bicycle, and on foot; (2) travel in jungles, mountains, high altitudes, steep terrain; (3) encounters with unfriendly persons; (4) sickness or injury where medical assistance may be substantially below standards of my home, unavailable, or not readily available; (5) where rapid evacuation is unavailable; (6) violence, crime, or hostility is common and unregulated; (7) natural forces cause injury or damage; and (8) other dangers may occur.
I understand that A.C.T. Intl is not insured for my benefit and that A.C.T. Intl categorically denies all responsibility for injury, loss, or damage.
I understand that I am required to carry or obtain medical insurance, including evacuation coverage.
I understand that travel insurance covering personal injury, trip delay, change or cancellation, loss of or damage to baggage, and other standard risk coverage for this trip is recommended. I also understand that A.C.T. Intl has instructed my travel insurance to include air flight service in the event of an illness or death, and the repatriation of my remains to my home in the USA.
I am fully responsible for my actions. I assume all risks and hazards of loss, injury, sickness, death, and damage to my personal property, including, but not limited to, risks of delay, change, or cancellation of travel arrangements, which I may suffer as a result of participation in the Event.
I RELEASE, DISCHARGE, AND HOLD A.C.T. INTL HARMLESS AND INDEMNIFY A.C.T. INTL, ITS DIRECTORS, OFFICERS, AGENTS, EMPLOYEES, TRIP LEADERSHIP, COORDINATORS, FACILITATORS, VOLUNTEERS, AND OTHER TEAM MEMBERS FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS, ACTIONS, WHICH ARISE FROM, OR ARE IN ANY WAY CONNECTED WITH MY PARTICIPATION IN THE EVENT WITHOUT REGARD TO WHEN I BECOME AWARE SUCH LIABILITY, CLAIM, DEMAND, OR ACTION.
I WILL NOT TO MAKE A CLAIM, FILE SUIT OR DEMAND ANYTHING FOR ANY LOSS, INJURY, SICKNESS, DEATH, AND DAMAGE TO MY PERSONAL PROPERTY THAT ARISES FROM MY PARTICIPATION IN THE EVENT.
I WILL PAY COSTS, INCLUDING, BUT NOT LIMITED TO, LEGAL EXPENSES OF A.C.T. INTL, ITS DIRECTORS, OFFICERS, AGENTS, EMPLOYEES, TRIP LEADERSHIP, COORDINATORS, FACILITATORS, VOLUNTEERS, OTHER TEAM MEMBERS AND OTHER EVENT PARTICIPANTS AS A RESULT OF ANY CLAIM OR SUIT FILED BY ME OR ANYONE ELSE AS A RESULT OF MY CONDUCT.
I WILL PAY FOR ANY MEDICAL TREATMENT RENDERED TO ME BY ANYONE RESULTING FROM MY PARTICIPATION IN THE EVENT.
I authorize A.C.T. Intl and its agents to arrange for transportation, food, and lodging for me on this trip and I commit to pay all expenses arising out of the same.
I authorize A.C.T., Intl. to use my name, image, and statements made by me in any form in perpetuity for any lawful purpose. I waive any right to inspect or approve the same. I release A.C.T., Intl., its licensees, successors, assigns, and agents from any claim arising from its use of my name, image, and statements.

This agreement binds me and my heirs, estate, legal representatives, powers of attorney or agent acting on my, or my estate’s behalf, at any time or any minor on whose behalf I execute this agreement as a parent or legal guardian, including such minor’s heirs, estate, legal representatives, powers of attorney or agents acting on the minor’s or the minor’s estate’s behalf. Any reference to “me,” “my,” or “I” in this agreement shall be read to include the minor on whose behalf I am executing this agreement and whose name is printed below.

DIGITAL SIGNATURE of MINOR and PARENT or LEGAL GUARDIAN of minor

I have read and understand this entire agreement. I have particularly noted those paragraphs in all capital letters, and I understand that I may be waiving my legal rights by executing this agreement and I intend to do so as consideration for my participation in the Event. I have had the opportunity to have this agreement reviewed by an attorney on my behalf.

Full Legal Name of Minor:	Full Legal Name of Parent or Legal Guardian:
Date:

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All minors (under the age of 18) must have a parent or legal guardian sign the RELEASE AND WAIVER AGREEMENT and the POLICY AGAINST SEXUAL HARASSMENT on behalf of the Minor.

As a short-term volunteer staff person of Artists in Christian Testimony Intl (A.C.T. Intl), you must agree to the following Policy Against Sexual Harassment

PHILOSOPHY

It is our firm and sincere conviction based upon scripture that the obedient Christian live a chaste life, avoid the appearance of evil, and take responsibility for all personal communications whether sent directly or inferred. Therefore, anyone suggesting, speaking, or making an innuendo which is implicitly or explicitly sexual will be violating the policy of Artists in Christian Testimony Intl and, therefore, subject to discipline. The State of Tennessee and the United States Federal Law forbid sexual harassment. In this they do well, but God has already charged us to walk righteously and purely. Hence, this statement is not merely a legal one, but also one of personal morality and righteousness.

POLICY

It is the policy of Artists in Christian Testimony Intl to provide all of its employed and volunteer staff with a work and ministry environment that is as free of unlawful discrimination as possible.

Harassment of staff members by coworkers, supervisors, managers, or vendors will not be permitted regardless of their working relationship. Harassment and reprisals for reporting harassment are serious offenses of Artists in Christian Testimony Intl’s work rules, and offenders will be subject to discipline up to and including termination.

GENERAL STATEMENT

Sexual harassment is first and foremost prohibited by the standards of Christian behavior set out in scripture, and as such, it is expressly against ministry policy. It is also a violation of the sex discrimination provisions of applicable federal, state, and local law. Every applicant and staff member should be free of discriminatory intimidation based on gender, as well as race, religion, color, national origin, age, or disability.

As a preventative measure, the ministry condemns any conduct under the definition of sexual harassment and will investigate and resolve all alleged complaints. There will be no retaliation against any staff member for filing complaints.

DEFINITION

Sexual harassment will be defined in the following terms:

Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when:

Submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s service or employment (example: a promise of continued service or employment or a threat of termination based on submission); or
Submission to or rejection of such conduct by an individual is used as the basis for service or employment decisions affecting such individual (example: poor job evaluations or failure to increase income as a result of rejection of such conduct); or
Such conduct has the purpose or effect of substantially interfering with an individual’s work performance or creating an intimidating, hostile, or offensive working environment (example: lewd comments, dirty jokes, nude pictures, obscene gestures, etc.)

Sexual harassment is not limited to supervisor/subordinate relationships, but can involve fellow employees, volunteers, or non-employees. As employers or directors, we may be held responsible for the actions of our staff members, managers, supervisors, and even non-managerial employees or staff members. In certain cases, we may be held responsible for acts of harassment by customers or other guests in the workplace or ministry activities if we fail to take immediate and appropriate corrective action, even though such conduct was not authorized or was clearly prohibited by ministry policy. Therefore, it is Artists in Christian Testimony Intl's policy not only to prohibit all harassment, but also to take prompt and appropriate corrective and preventative action in the event any violation of this policy occurs.

COMPLAINT PROCEDURE

Any staff member who believes he or she has been the victim of, or who is aware of, sexual harassment should promptly report this problem to his or her immediate supervisor or the executive director. All such complaints must be made and/or confirmed in writing. Supervisors are to report all complaints to the executive director for investigation. All information relating to such a complaint shall be kept absolutely confidential.

INVESTIGATION—DETERMINATION

Following its receipt in writing, all complaints will be investigated in accordance with the grievance procedure set out in the Staff Policy Manual. All relevant facts, including the context in which the alleged incident occurred, will be evaluated on a case-by-case basis in determining whether an action does, in fact, constitute a violation of this policy. In determining whether a specific action is, in fact, a violation, the scripture will be our first point of reference. We will also utilize the criteria proscribed by Title VII of the Civil Rights Act of 1964, as amended, and the Guidelines on Discrimination Because of Sex issued by the Equal Employment Opportunity Commission, and this policy.

Such considerations include:

Whether submission to the conduct is either an explicit or implicit term or condition of employment or volunteer service.
Whether submission to or rejection of the conduct is used as a basis for an employment or volunteer service decision.
Whether the conduct has the purpose or effect of unreasonably interfering with a staff member's performance or creating an intimidating, hostile, or offensive work or ministry environment.

CONFIDENTIALITY

Due to the sensitivity of sexual harassment complaints, each allegation will be expeditiously and appropriately investigated. All such investigations will be conducted in a discreet and sensitive manner. However, scripture precludes “secret investigations” and charges that each person is entitled to be confronted by his or her accuser. However, all such procedures will be conducted in a manner that will protect the privacy and minimize accusation and suspicion of all parties involved.

STAFF MEMBER RESPONSIBILITY

Recognizing that such conduct is a matter of personal morality and righteousness before God, every staff member is responsible for refraining from conduct or language which would be defined as sexual harassment.

MANAGEMENT and DIRECTOR RESPONSIBILITY

It is the responsibility of each manager and director to demonstrate and uphold scriptural behavior in all aspects of the ways in which they deal with those responsible to them. As such, they are responsible for the full implementation of this policy and for the creation and maintenance of a positive environment in the workplace free of sexual harassment. In addition, they are responsible for communication of this policy to all of their subordinates.

REMEDIAL ACTION

Should the investigation disclose a violation of this policy, appropriate disciplinary action, up to and including discharge, will be taken.

RETALIATION OR REPRISAL

Retaliation or reprisal against persons making complaints is prohibited and will not be tolerated.

All minors (under the age of 18) must have a parent or legal guardian sign the POLICY AGAINST SEXUAL HARASSMENT on behalf of the Minor.

Signature below by parent or legal guardian indicates that the adult is vouching for the minor's understanding of and adherence to this policy.

DIGITAL SIGNATURE of MINOR and PARENT or LEGAL GUARDIAN of minor

I have read and understand Sexual Harassment policy.

Full Legal Name of Minor:	Full Legal Name of Parent or Legal Guardian:
Date:

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