EMAS CANADA—Education, Medical Aid & Service


Angola \| China \| Congo \| Costa Rica \| Ecuador \| Haiti \| Kenya \| Malawi \| Mongolia \| Philippines \| Romania \| Russia \| Uganda \| Ukraine \| Vietnam

All those approved, are sponsored by EMAS. They are expected to collect donations to cover the expenses incurred on their behalf.

If you are interested in participating on an EMAS Mission Trip, please check the upcoming trip schedule to see which missions team you would like to join; note the dates; then choose from the following options:

Option 1 - Click to access a printable Application Form here. Print a copy, fill it out and fax it to the EMAS National Office, or scan the completed form and e−mail it to ~ . Note: (Acrobat Reader is required to view the pdf Application Form. If you do not have it already installed on your computer, click here to download it safely, FREE from the Adobe website.)

Option 2 - Fill out the on-line form below and "Submit" to the EMAS Office.

Missions Team
Participant Application

Destination Country
Date of Trip

First Name
Last Name
Home Address
Home Address 2
Office Address
Office Address 2
Home Phone
Work Phone
Cell Phone
E-mail

Date of Birth
Citizenship
Skill
Professional Qualifications
Year of Graduation
Degree
Specialty
Other Qualifications

Emergency Contact Name
Emergency Contact Tel. No.
Emergency Contact E-mail

Church Member or Adherent?
Previous Overseas Experience
What do you hope to contribute to this mission?
Statement of Faith Apostles' Creed I believe in God, the Father almighty, creator of heaven and earth. I believe in Jesus Christ, God's only Son, our Lord, who was conceived by the Holy Spirit, born of the Virgin Mary, suffered under Pontius Pilate, was crucified, died, and was buried; He descended to the dead. On the third day He rose again; He ascended into heaven, He is seated at the right hand of the Father, and He will come again to judge the living and the dead. I believe in the Holy Spirit, the holy catholic1 church, the communion of saints, the forgiveness of sins, the resurrection of the body, and the life everlasting. _____________________ 1. The word "catholic" refers not to the Roman Catholic Church, but to the universal church of the Lord Jesus Christ.
Are you able to sign the above Statement of Faith?

If you are unable to sign the above Statement of Faith, or if you wish to discuss it, please explain.
Representations and Acknowledgment The undersigned represents and warrants to EMAS the following: (a) The undersigned is in good physical and mental health and is fully capable of undertaking the assignment to which this application relates; (b) The undersigned has never been convicted of a criminal offence in Canada or elsewhere. The undersigned further acknowledges that engaging in the assignment to which this application relates may involve personal risk of exposure to communicable disease, bodily injury or kidnapping. The undersigned acknowledges that although EMAS makes every effort to ensure the safety of its volunteers, in the unlikely event of a kidnapping incident, it is the policy of EMAS not to pay ransom to any individual, group or government demanding payment for the release of overseas personnel. The undersigned acknowledges that the undersigned understands and accepts the foregoing policy. WAIVER OF RESPONSIBILITY As part of your application we would ask you to sign the release and indemnity below. As a result, you and your family will absolve EMAS CANADA, and any respective directors, officers, employees and agents, from any liability that may arise as a result of your participating in the activities of the above mentioned organization. As well, you agree to indemnify the directors, officers, employees and agents of the above named organization from any and all actions that may be brought as a result of your participation in the activities of the above named organization. The foregoing is an attempt to summarize the effect of the release and indemnity but does not affect the terms thereof. RELEASE AND INDEMNITY IN CONSIDERATION of the benefits derived, if accepted by EMAS as a team member, and other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned for himself, and his heirs, executors, personal representatives, successors and assigns hereby releases and forever discharges EMAS CANADA and its respective directors, officers, employees and agents (including team leaders) of and from all manner of actions, causes of action, suits, debts, dues, accounts, bonds, covenants, contracts, claims and demands whatsoever which the undersigned has or hereafter can, shall or may have for or by reason of any injury, damage or loss that may be sustained, however caused, in consequence of, or in any way related to the activities of the above named organizations. AND FOR THE CONSIDERATION aforementioned, the undersigned further agrees to indemnify and save harmless the directors, officers, employees and agents (including team leaders) of EMAS CANADA from all manner of actions, causes of action, suits, debts, dues, accounts, bonds, covenants, contracts, claims and demands whatsoever which arise, directly or indirectly, from the undersigned's activities, whether on behalf of the above named organizations or otherwise. AND I am fully aware and acknowledge the risk involved in the participation of the said activities, and that notwithstanding same, I am voluntarily proceeding with the undertaking and I am assuming all of the risk of injury, damage or loss to me and the others in connection therewith.
I have read and accept the above terms, waver and release, as stated.
Date
Signed by
Witnessed by

Thank you for completing this application. It will be reviewed by an EMAS Team Leader. You are not a team member until you hear from EMAS as to whether or not you've been approved. Also note that some of the missions team leaders have additional requirements. If your application is accepted, you will be advised if additional information is needed.