Domestic Outreach Trip Application
If you are interested in joining a Freedom 4/24 domestic outreach trip, please complete the application below. Be advised you cannot save any part of your application online.

If selected as a team member, a nonrefundable, tax-deductible deposit of $300 will be due, and a criminal background check will be completed. If you have questions please call the office at (434) 582-4517 or email

Full Name *
First Middle Last Name
Your answer
Gender *
Street *
Your answer
City, State, Zip *
Your answer
Email *
Your answer
Phone Number *
Your answer
Date of Birth *
T-Shirt Size *
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