Career Global Worker Agreement Form

* Indicates required fields.

*International Location/Country:

Personal & Medical Information

*Name: (The name you go by)

*Date of Birth: (YYYY-MM-DD)

*Birth Place:

*Citizenship:

*Street Address: (in Canada)

*Town/City:

*Province:

*Postal Code:

*Country:

*Phone Number:	*Email:
*Gender: MaleFemale	*Marital Status: SingleMarried

Name of Spouse: (if applicable)

Spouse's Date of Birth: (YYYY-MM-DD)

Name of Children: (if applicable)	Children's Date of Birth: (YYYY-MM-DD)

*Emergency Contact Name:

*Emergency Contact Phone Number:

Do you, your spouse or child(ren) have any medical condition(s) that we should be aware of that affect your ability to go to or stay on your field of service? If so, please describe:

Are you, your spouse or child(ren) taking any medication(s) that we should be aware of that affect your ability to go to or stay on your field of service? If so, please list:

Passport Information

(For Global Workers deployed outside of Canada)

*Name: (Exactly as it appears on your passport)

*Passport Number:

*Country Issued:

*Expiration Date: (YYYY-MM-DD)

Please add your Spouse's passport information, if applicable.

Spouse's Name: (Exactly as it appears on your passport)

Passport Number:

Country Issued:

Expiration Date: (YYYY-MM-DD)

Please add your child(ren)'s passport information, if applicable.

Child's Name: (Exactly as it appears on your passport)	Passport Number:	Country Issued:	Expiration Date: (YYYY-MM-DD)

Any additional questions and/or comments?

Acknowledgement & Signature

Please read the following agreement and waiver carefully. It includes releases of liability and waiver of legal rights and deprives you or any others of the ability to sue certain parties. By agreeing electronically, you acknowledge that you have both read and understood all text presented to you as part of the registration process.

Please Note: All of the following checkboxes and fields are required and therefore MUST be selected/filled in order for this form to be processed.

I, the undersigned, wish to participate as a Global Worker in the country selected above, conducted under the auspices of Apostolic Church of Pentecost of Canada Incorporated (ACOP), Global Harvest and Beyond. By selecting the following checkboxes and signing this form, I (and my immediate family, if applicable) acknowledge:

My readiness to endure the challenges I may face, and to engage in loving service for the Lord and a lost world.

My expectation to complete the ministry agreed upon unless matters beyond my control are permitted by the Lord to close the door for me. If there is a ministry change, I agree to consult with & seek direction from ACOP/Global Harvest/Beyond before making the change.

My supreme purpose in serving as a Global Worker is to glorify Christ through widespread witness, through winning souls, through discipling, all for the building of the Church of Jesus Christ.

I am fully aware of the potential risks and hazards connected with travel to and within this country, and I voluntarily assume full responsibility for any risks of loss, property damage or personal injury that I may sustain as a result of participating in this project. I release ACOP / Global Harvest and their employees, agents, trustees, directors and other officers from any liability for injury, damage, or harm which may occur to my person or property in connection with my participation in this short-term mission project, whether upon the premises where the project is being conducted, while in transit to or from the premises, or in any place or places connected with this project.

I understand that neither ACOP, Global Harvest or Beyond carries liability insurance to insure against any of the risks I may encounter travelling to or in the country listed above. I am covered for medical emergencies.

I confirm that I have consulted with my family physician and have received the recommended inoculations and/or medications required to travel to the destination indicated above. I affirm that any medical history and/or pre-existing medical conditions will not prevent me from safely travelling to or from the aforementioned destination, affect me while at the indicated destination or while I’m participating in proposed travel activities.

I have reviewed the security situation and travel advisories for the area that I will be travelling. View Travel Advisories

I have discussed with my immediate and extended family members in Canada the security situation of the area to which I am travelling and have advised them that ACOP, Global Harvest or Beyond is not sending me to any area listed as “Avoid all Travel”.

I give ACOP, Global Harvest and Beyond and their representatives in my country of posting 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 the field, including, without limitation, while travelling to and from any foreign country. I agree to pay the cost of any such treatment not covered under my insurance policy and to reimburse ACOP, Global Harvest or Beyond and their representatives for any and all costs and expenses incurred with respect to such treatment.

It is my express intent that this release shall bind the members of my family and spouse (if applicable), my executor, administrators and heirs, and shall be deemed as a release, waiver, discharge and covenant not to sue ACOP, Global Harvest, Beyond or their employees, agents, trustees, directors or other officers.

I have read, understood and will follow applicable Security Protocols (for Beyond Global Workers) View Beyond Security Protocols

I have read the foregoing release, understand it, and sign it voluntarily and without duress.

I agree that by typing my full name below that I am electronically signing this document.

*Date Signed: (YYYY-MM-DD)

*Electronic Signature: (Your full legal name)