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StudentLife MIDDLE SCHOOL Mission Trip: Birmingham 2026 Application on Wednesday, December 31, 2025

Price:

no cost

*Attendee's First Name:

*Attendee's Last Name:

*Attendee's Email Address:

*Attendee's Phone Number:

Country:

Address Line 1:

Address Line 2:

City, State Zip:

MS Mission Trip 2026 Application

Application Due Date: Wednesday, December 31, 2025

This application is to be filled out by the student wishing to go on this mission trip and digitally signed by the student and by the student's parent/guardian.

Student, please fill in your contact information below.

*Student's Grade

*Student Cell #

*Student Email

*Do you attend CLC on a regular basis?

YES, I attend at least twice a monthYES, but usually less than twice a monthNO, I do not attend CLC

*Briefly share your testimony

*What is God doing in your life right now?

*How are you currently participating in church and our youth group?

*Why do you want to go on the mission trip?

*Do you have any mission experience?

YesNo

*If "YES", when and where?

*Are you applying for the mission trip scholarship program?
Applying for the scholarship program does not guarantee that you will be accepted to go on this trip or that you will be a part of the scholarship program. All applications need to go through an approval process.

If you COMPLETED the Mission Trip Scholarship Program before, you are ineligible to apply for it again.

No, if accepted, I do not plan to apply for the scholarship program.Yes, if accepted, I plan to apply to the scholarship program.

MISSION TRIP SCHOLARSHIP PROGRAM APPLICATION

Student, since you are interested in participating in the Mission Trip Scholarship Program, please fill out the Scholarship Program Application below.

TOTAL COST PER STUDENT (2026): $575

REQUIRED DEPOSIT: $175

SCHOLARSHIP AMOUNT REQUESTED: $400

*Reason assistance is needed. Please be specific:

END OF SCHOLARSHIP PROGRAM APPLICATION

STUDENT COMMITMENT

If selected, I commit to going on the 2026 mission trip to Birmingham, Alabama from July 19 – 26, 2026. The total cost of this Mission Trip is $575. I am committing to raising all the funds for this trip.

My parent or guardian is aware of my plans to go on this trip! As a sign and seal of my commitment to go on this mission trip, I am committing to paying the non-refundable $175 deposit for my trip as soon as I am selected to go on this trip but no later than January 18, 2026.

I promise to do my best to raise the additional $400 (amount left after deposit) by doing fundraisers and writing support letters, and I/or my family and I will fund the remaining amount. It is my mission to go to Birmingham, Alabama this summer to share Jesus’ love with the people of Birmingham.

I will do everything in my power to get myself there including raising support and attending meetings, training days (February 22, March 29, April 26, May 31, June 28), LoveDayton, and attending at least 12 StudentLife Middle School Sunday services, and at least 4 Wednesday night StudentLife services before the trip.

Typing my name below signifies I, the student wishing to participate in this mission trip, understand and voluntarily agree to the above Student Commitment Statement:

PARENT/GUARDIAN COMMITMENT

I/We, the parent/s or guardian/s of the student named above, commit to support our student as he/she participates in the preparations and in the actual mission trip.

Typing my name below signifies I understand and voluntarily agree to the Parent/Guardian Commitment Statement::

MS Pastor's Signature:

Again, many factors will go into the acceptance process including age, involvement, maturity, readiness, and commitment.

QUESTIONS? Please see Pastor Aaron before or after services or email him at: aseelbaugh@clcdayton.org

Registration Total:

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Event Registration

StudentLife MIDDLE SCHOOL Mission Trip: Birmingham 2026 Application on Wednesday, December 31, 2025

MS Mission Trip 2026 Application

Application Due Date: Wednesday, December 31, 2025