Short-term Mission Trip

We have 3 super easy steps to register your team for the mission trip. Please be sure to fill out this form completely. Use one form per group. Once you have completed the form, you must submit it along with your payment to apply.
The cost to apply is $25 for each member of the group, it is non-refundable and non-transferable.

Step 1 of 3

Group Leader Name *

Email Address *

Phone Number *

Address *

Group Name *

Starting Date *

End Date *

Emergency Contact Name *

Emergency Contact Phone *

Comments or Questions

How many team members would you like to register? *

How many single women in total? *

How many single men in total? *

How many married couples in total? *

How many children in total? *

Please write the name, age and gender of each team member.

I have been informed of the above activity sponsored by Youth With A Mission Puerto Viejo and hereby voluntarily consent to participate in this activity. I understand that the leaders of this activity will take all reasonable safety precautions, and I acknowledge that the possibility of unforeseen danger exists. In consideration of Youth With A Mission in Puerto Viejo (YWAM) in organizing, allowing me to attend and participate in the event described above and any related activities, I waive all rights that I may now have or may accrue in the future against YWAM, directors , officers, employees, and members (collectively, the "YWAM Representatives") and hereby release YWAM and the YWAM Representatives from all liability, and agree to indemnify and hold YWAM and the YWAM Representatives harmless. and against liability for any and all actions, damages, causes of action, demands, costs, losses, expenses, claims, demands, and judgments (collectively, the “Losses and Claims”), that I, my spouse, members of the family, children, guests, heirs, executors, administrators, successors and assigns, now have or may appear in the future as a result of my travel, attendance or participation in YWAM. I acknowledge that certain legal rights against YWAM or YWAM Representatives may be available to me now or in the future as a result of any loss and claim, and that by executing this release and release, my spouse and I are forever waiving those Rights against YWAM and YWAM Representatives. I acknowledge that YWAM or YWAM Representatives made no promises, representations or statements of fact to me regarding the safety of the event or related activity, the safety precautions taken in sponsoring the event, the relative safety or danger associated with traveling to the event. event or participate in any activity or outing related to or in any way related to the event. I affirm that I have read and understand the above provisions of this Release of All Claims, Release of Liability, Assumption of Risk, and Indemnity Agreement and agree to its terms as a condition of my attendance at this event. *

Yes, I agree

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