CCCM CreationFest 2021 Team Application

July 23- August 7, 2021
More Information contact Nicolette at nwalker@cccm.com

1Personal Information > 2Spiritual Information > 3Review Your Entry
Please attach a recent photo

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Personal Information
Name As it Appears on Your Passport Name As it Appears on Your Passport * Title First Middle Last Suffix
Do You Currently Have a US Passport? *

Do You Currently Have a US Passport? Yes No No, but I do have a passport from another country
Where did you hear about Creation Fest? *
Have you been a part of the CCCM Creation Fest Team in the past 2 years? *
If you have attended in the past 2 years...

Please only fill out the required sections with a red star
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Sex *

Sex Male Female
Age *
Date of Birth Date of Birth * / MM / DD YYYY
School (if applicable)
Grade (if applicable)
Cell Phone Cell Phone * - ### - ### ####
Email *
Parent's Names (for minors only)
Parent's Phone (for minors only) Parent's Phone (for minors only) - ### - ### ####
Parent's Email 1 (for minors only)
Parent's Email 2 (for minors only)
Health Info
Do you have any physical concerns or limitations that might be a concern on this trip? If so, please describe:
Please list any hospitalizations in the last two years:
Are you currently taking any prescription medication? If so, please describe the medication and purpose:
Practical Info
Have you ever been out of the country before?

Have you ever been out of the country before? Yes No
Where?
Have you ever been on a missions trip before?

Have you ever been on a missions trip before? Yes No
Where?
Do you have any concerns with traveling (air sickness, travel history)?

Do you have any concerns with traveling (air sickness, travel history)? Yes No
If yes, please explain
Do you have any dietary restrictions (including allergies) or preferences?

Do you have any dietary restrictions (including allergies) or preferences?
Yes No
If yes, please explain
Please select all that apply:

Please select all that apply: I am known to snore I am an early riser I am a night owl I am willing to cook meals for my cottage mates. I am not able to stand long hours Any other personal habits? Any other personal habits?

This is for our planning process, but please know the days are long and we all work together. Please let us know if you have any concerns with this.
How are you planning to pay for this trip?

How are you planning to pay for this trip? Personal Family Help Fundraising
Other
Please list any talents or other skills/work experience that may be useful at the festival (photography, drama, barista training, musical talents, handyman, kids/youth work, etc.)
Emergency Info

In case of an emergency, who would you like us to contact?
Full Name *
Relationship *
Cell Phone Cell Phone - ### - ### ####
Alternate Phone Alternate Phone - ### - ### ####
Email *
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Enter Your Email Address *

A special link to resume the form will be sent to your email address.

CCCM CreationFest 2021 Team Application

CCCM CreationFest 2021 Team Application

Personal Information

If you have attended in the past 2 years...

Health Info

Practical Info

Emergency Info