Firstname

Lastname

Email Address

Phone

Nationality

Geburtsdatum

Why do you want to join this trip?

What do you expect from this trip?

For how long have you been saved? What does your walk with the Lord currently look like?

Are you living in sin (sexual sin, addictions, drugs, ...)?

Do you have any traumas? Do you have any traumas? Yes No

Do you have any sicknesses? Do you take any medication? Do you have any sicknesses? Do you take any medication? Yes No

What traumas do you have?

Which sickness do you have? Which medication do you take and how often?

What church are you part of?

Where do you life?

What's the name of your pastor/small group leader? How could we contact them?

Are you financially able to cover the trip costs? Are you financially able to cover the trip costs? Yes No