We are so glad to have you on our Team!

Please fill out all of the information below to the best of your ability.

This is to help us better understand your needs, and improve your overall experience.

All information will be sent to a team coordinator and kept 100% confidential.

Name *
Address *
“I/we hereby consent to allow any medical treatment necessary to be administered to myself or my minor son/daughter while traveling to and from, or during the Navajo Nation Christian Response Team. I/we assume full medical, financial, and legal responsibilities for any costs involved in treatment, and release all members of the Navajo Nation Christian Response Team, “Cornerstone Ministries,” “Western Indian Ministries” and other participating organizations, from liability for any accidental injury or death. By signing I also give permission to N.N.C.R.T. to use any media content (photo/video/audio recording) of me to be used by the Navajo Nation Christian Response Team to use in their publications and/or Web site and/or videos. I understand that my name may, in some cases, be used with my picture. I agree that I will not be compensated for such usage.