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African American Baptist Mission Collaboration (AABMC)
Laborers together for Christ
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November 2015 - Team Impact - NBCA/LC Men on Missions
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Haiti COED STM - May 4 - 11, 2019
How many people are you registering?
Fill in your registration information on this page. If you are registering additional people, you will be able to enter their registration information after you complete this page and click "Continue".
Please enter a Username to create an account. If you already have an account
before completing this form.
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.
Service Trip Registration Information
Preferred Departure City
Full Legal Name
Passport Expiration Date
Place of Issuance
Emergency Contact Information
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone
Emergency Contact Email
Are you a Christian?
What does service mean to you?
What church do you attend? Pastor?
Is your church supportive of your mission effort?
What do you hope to contribute to this missionary experience (whatever it may be)?
List three things you hope to learn on the trip
What skills and talents do you have which may be beneficial on the mission field?
What are your spiritual gifts?
Known medical conditions
Cross Cultural Experience
Is this your first AABMC mission trip?
If this is not your first AABMC trip, please list previous locations
List any other previous mission experiences
List any languages you speak fluently
I do hereby give AABMC/Lott Carey Inc., and its representative(s) authority to request and authorize medical and/or hospital treatment for my benefit in the event of any injury or sickness sustained by me while on any such travel, stay or other activity, including, without limitation, while traveling to and from any foreign country. I agree reimburse Lott Carey for any additional costs and expenses incurred with respect to such treatment that is not covered by (or over and above) the Missions Insurance and my personal health insurance.