CHILDREN (list names, ages and sex)


Please forward by e-transfer a $100 application fee in Canadian funds to, This application fee will be deducted from the total you owe for the trip. If you have questions concerning this form, please contact us at the email above.


Please list a couple of people who can act as a personal reference for you. Do not use members of your immediate family


I am prepared to give my best for the duration of the Seven Wells mission outreach. I am prepared to perform unpleasant orchallenging tasks with a servant heart. I am aware that the daily schedule in such a trip is very full and may be physically intensive. I am prepared to fully give of my talents and strengths, even when this means the giving up of my free time.

The information contained in this application is correct to the best of my knowledge. I authorize any reference or church listed in this application to give you any information they may have regarding my character and fitness for youth or mission work, and I release all such references from liability that may result from furnishing such evaluations to you.

Should my application be accepted, I agree to be bound by the policies of Seven Wells Ministries and refrain from unscriptural conduct while I am involved in the trip and/or preparations for. While on the outreach, I agree to be under the authority of the team leaders in matters of lifestyle and conduct.

I understand that payment of the fees for airfare will be required shortly after the flights are booked, which may be weeks or months prior to the start of the actual outreach. Such fees are normally paid directly to the travel agent who books the flights, not to Seven Wells. I understand further that the required ground fees must be made in Canadian currency shortly prior to the start of the outreach according to the schedule of payments which the leaders will make known within a reasonable time after my acceptance as a team member. Such payments will normally be required 2-3 weeks prior to the start of the outreach, in order to allow sufficient time for bookkeping and currency conversion.

I agree to obtain the necessary medical shots for travelling overseas to the outreach location, at my own expense. These are not included in the outreach fees. I further agree to arrange, at my own expense, for emergency medical insurance to cover me in the case of accident or illness while on the outreach, and agree that Seven Wells is not responsible for any medical expenses incurred while on outreach, whether due to accident or illness. I also warrant that I do not have any medical or physical condition which would make it inadviseable to participate in this outreach.

There will be photos and videos taken of this mission trip, which may be used in newsletters, videos, or other promotional materials for the purposes of promoting the work of Seven Wells. I hereby give permission for Seven Wells to use photos and/or videos in which I appear for such purposes.

I also agree to provide the necessary forms for police and child abuse registry checks, at my own expense, in reasonable time before the outreach.