2026 GLEANINGS Mission Trip Application

Dates: Sunday, Nov. 8 - Friday, Nov. 13
Cost: $250
Application Due Date: July 5, 2026
Location: Dinuba, California
Team Leader: Pastor Nathan

General Information

Name

Birthdate (month/day/year)

Address

Cell

This address will receive a confirmation email

Gender

Emergency Contact Information

Name

Relationship

Cell Phone Number

Health Information - Required

Do you have health insurance?

If you have health insurance, please upload a picture of your insurance card's front.

Upload (8MB)

If you have health insurance, please upload a picture of the back of your insurance card.

Upload (8MB)

List prescription medication you are taking and amounts and when taken (n/a if none):

List any chronic diseases, medical restrictions, special dietary needs or allergies (n/a if none):

Questions

1. Have you been on a mission trip before?

Yes No

If yes, where and when was your most recent trip?

2. Why do you want to go on this particular trip?

3. Share about your relationship with Jesus right now:

4. How do you typically handle conflict or disagreement in a team setting?

5. What gifts, talents, or abilities are you willing to offer as a member of this team?

6. Have you shared with your family your intentions to go on this trip?

Yes No

7. What was their response to your decision to go on this trip?

Enthusiastic Supportive Skeptical Negative Haven't talked to them about it yet

8. What fears or concerns do you have about this trip?

Participant Covenant and Agreement

A covenant is an unconditional, lasting promise. Please read carefully and prayerfully. By signing below, I am committing to honor this covenant and the expectations of Summit Church.

Trip Commitment
- I am committing to the Gleanings for the Hungry Summit Mission Trip to Dinuba, CA in 2026.
- Approximate cost: $250
- $100 non-refundable deposit due with application by July 5, 2026.
- I am responsible for the full cost of the trip.
- I will participate in required meetings, trainings, and preparation gatherings.

Spiritual Commitment
- I will prepare spiritually through church attendance, prayer, and time in God’s Word.
- I understand I represent Jesus Christ and Summit Church at all times.
- I will serve with humility, maturity, flexibility, and a servant’s heart.

Team & Cultural Commitment
- I will pursue unity and handle conflict biblically.
- I will submit to team leadership.
- I will honor the culture and community we are serving through respectful words, dress, and conduct.
- If fundraising is required, I will actively participate.

Team Expectations
- No alcohol, illegal drugs, tobacco, or vaping products (including travel).
- No weapons or lighters.
- Modest dress and respectful behavior.
- Full participation in all group activities.
- Be punctual and dependable.
- Be a team player.
- Treat teammates and those we serve as brothers and sisters in Christ.
- Use wisdom and discretion on social media.

Accountability
- I understand that failure to uphold this covenant may result in being sent home at my own expense at the discretion of trip leadership.

Questions?
Pastor Nathan Nash
605-480-3191 | nathan@summitwy.org

I have read, understand and agree to the trip covenant and commitments:

Yes No

Do you understand that this trip requires flexibility, a servant's heart, and a commitment to the team and people we serve?

Yes No

If you're under 18 years old, please have your parent/guardian provide their full name & phone number (if you're over 18 enter n/a):

Please type your full name as a signature agreement:

Date:

Payment Information

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2026 GLEANINGS Mission Trip Application

Description

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