GO Team Application - Missouri 2023

Applications due Thursday, January 12, 2023

Application Process:

1. Read the Trip FAQ sheet HERE.
2. Complete the application (below)
3. If all of this is completed on time, the trip leader will contact you within 4-6 weeks of the application deadline to let you know whether you have been selected.

All information on this form will be kept confidential, with disclosure related only to trip placement (Impact staff, Trip Leaders, Medical and Legal advisers, etc.) or as required by law.

*Address Line 1
Address Line 2
*Zip/Postal Code
*Preferred method of contact:
*Date of Birth:
*Will you be 18 years old or older by the starting date of the trip?
*Current Grade in School (2022-23):
*School Name and School District you attend:
*Please indicate your country of citizenship:
*What is your full legal name (including middle name) as it would appear on an airline ticket:
*Trip ID:

Parent (or legal guardian) info

*Parent # 1 Name:
*Parent #1 Email:
*Parent #1 Phone:
Parent #1 secondary phone:
*Parent #1 Relationship to student:
Parent #2 Name:
Parent #2 Email:
Parent #2 Phone:
Parent #2 secondary phone:
Parent #2 relationship to student:

Your Participation in the Trip

Team Meetings
Below are the dates for the Go Team meetings. Please indicate whether you can attend each meeting. Attendance at these meetings is expected by all team members.
*Sunday, February 12 from 3:00 - 5:45pm (Parents & Students for first 30-60 minutes, students only for remainder of meeting):
*Sunday, March 12 from 3:30-6:00pm:
*Sunday, April 16 from 3:00-5:30pm:
*Team overnight June 10 (morning)- June 11 (afternoon) - Location TBD:
*Sunday, June 25 - Final Preparations Meeting (time TBD):
*Sunday, July 30 - Celebration Trip Presentation (time & date subject to confirmation):

Your Interest in the Team
*If there are any obstacles that might keep you from going on this trip or attending any of the team meetings, please explain them below.
*What are some things you have heard about the Missouri GO Team trip that have made you excited to apply for the team?
*Please explain your primary reasons for applying for and desiring to be a part of this GO Team trip
*Support raising is a required aspect of going on a GO Team trip. Support raising is beneficial for team members as it teaches them the importance of relying on God and fellow believers for financial, prayer, and emotional support. Where do you anticipate the funds for this trip to come from?

Gifts & Skills

Spiritual Gifts If you have taken a spiritual gifts assessment in the past, please indicate your top three spiritual gifts.
My Spiritual Gift 1:
My Spiritual Gift 2:
My Spiritual Gift 3:

Skills (check all that apply)
*How do you wish to serve on this team?:

Spiritual Info

*Are you are regular attender of Blackhawk Church?:
*Which site do you typically attend?:
How long have you been attending Blackhawk Church?:
If you attend another church, indicate the name:
*Where did you first learn about Jesus Christ? What are you currently doing to help you learn more about Jesus or to connect with him?
*Briefly describe your personal beliefs about Jesus
*Are you involved in HSM Community Groups?:
If so, what Community Group are you a part of?:
If no, why not?:
If so, who is/are your small group leader(s)?:

Ministry Experience

*In what areas of the church are you currently serving or have you served recently?:
*Please describe what ministry experience you have had with adults and/or children (examples are things like working in the nursery, visiting nursing homes, working with people with special needs, etc.)
*Please describe any previous or current experience that you have working/volunteering in community service
*Have you ever been on a mission trip before?:
If yes, may we contact the trip leader?:
Leaders Name & Contact info:
If you have been on a mission trip before, please describe your experience. What did you do?

Background info

Information will be kept confidential, with disclosure only related to ministry services, or as required by law.

Health Background
*Do you have any medical conditions (e.g. diabetes, lactose intolerance, asthma, history of heart attack or stroke, etc.)? If so, please indicate here:
*Do you currently have or have you had in the past any mental health issues (depression, bipolar disorder, generalized anxiety disorder, history of psychiatric treatment or hospitalization, etc.). If so, please indicate here:
*Do you have any physical limitations or conditions that will prevent you from performing certain types of activities? If so, please indicate here:
Is there anything else the GO Team Leadership should know about your physical or mental health?

Social Background
*Do you have a drug, alcohol and/or anger problem? Does anyone who knows you think that you have a drug, alcohol and/or anger problem?  If so, please indicate here:
*Are there any past or present issues (spiritual, physical, emotional/mental, social), which would hinder your ability to work appropriately with children?  If so, please indicate here:
*Have you in the past or are you currently struggling with any addictions (alcohol, drug, pornography, etc.)?  If so, please indicate here:
*Have you ever been accused, charged, or convicted of a criminal offense (felony or misdemeanor) other than a parking violation?  If so, please indicate here:


*Blackhawk’s official current policy (as of November 2022) is that COVID vaccination and mitigation strategies (masking, social distancing, etc.) will not be required for GO Team participants unless required by our partner, transportation providers (airline, bus, etc.), or local government.  (As of November 2022, Camp Barnabas does not require COVID vaccinations or mitigations.  Blackhawk will continue to monitor the COVID situation and policies, and will communicate any changes as necessary.)
*In the event of a student participant contracting COVID while on the trip, that participant may need to be quarantined for a duration past the scheduled end of the trip, unless private family arrangements are made to pickup the student.  Quarantining would happen at Camp Barnabas until the participant is cleared to travel.  A minimum of two leaders would stay behind with the student, per Student Ministry policy.


References are required for consideration for this trip and to meet our Child Protection Policy standards. Please provide complete mailing addresses and email address for three references that have acquired accurate knowledge of your character and meet the following criteria:
  • known you for more than one year
  • at least 18 years old
  • not related to you
  • not your significant other (e.g., boy/girlfriend, spouse)
  • not a Blackhawk staff member
  • if possible, have witnessed you interacting with children.

***It is required that one of your references either be your HSM home group leader or a mentor to you.
*Reference #1 Name:
*Reference #1 Relationship:
*Reference #1 Email:
*Reference #1 Address:
*Reference #2 Name:
*Reference #2 Relationship:
*Reference #2 Email:
*Reference #2 Address:
*Reference #3 Name:
*Reference #3 Relationship:
*Reference #3 Email:
*Reference #3 Address:

Authorization and Consent

*For participants 18 years old or older, Blackhawk completes background checks upon the start of service, and then every three years for continued service. In the time between background checks, I understand that I am required to self-report any misdemeanor charges/convictions, felony charges/convictions or alcohol- or drug-related citations I receive during the season I am in service to Blackhawk.
Upon submitting this form, you will receive an email with instructions on how to provide background check information, if one is required. YOUR APPLICATION WILL NOT BE CONSIDERED COMPLETE UNTIL YOU HAVE SUBMITTED YOUR BACKGROUND CHECK via the instructions provided through that email.
By signing below I agree that the information provided in this application is true, and I authorize the Church (Blackhawk Evangelical Free Church and/or its representative) to verify the information on this form. I authorize any organizations, institutions, churches or references listed in this application to give the church any information (including opinions) that they may have regarding my character and suitability for participation in this trip. I hereby release any individual, organization, employer, church or reference from any and all liability for any damages that may at any time result to me, my heirs, or family, on account of compliance or any attempt to comply with this authorization. Should my application be accepted I agree to adhere to all policies of Blackhawk Church. 
If applicable and in the interest of safety and security I, the undersigned applicant, authorize Blackhawk Evangelical Free Church to procure background information about me, prior to, and at any time during, my service to the organization. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/records; and the state sex offender records. I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request. Also, I understand that I may receive a written summary of my rights under the Fair Credit Reporting Act.
*Signature (Typing your name here serves as your signature):

Parental Acknowledgement

Please have a parent or legal guardian fill out this section.
Do you support your student serving on this trip?:
Is there anything else that you would like us to know that would help improve your child's experience on the trip? (i.e. child's personality, fears, likes/dislikes, etc.)
Parent/Guardian Signature (Typing your name here serves as your signature):