Registration

General Information

Trip Month

To Country(Required)

Name(Required)

First Last

Passport #

Date of Birth(Required)

Gender

Marital Status

Occupation

Contact Information

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Primary Phone(Required)

Work Phone

Email Address(Required)

Emergency Contact(Required)

First Last

(not going on this trip)

Emergency Contact Number(Required)

Medical History

Is there any health information your trip leader should be aware about?

(i.e. disability, allergies, dietary restrictions, diabetes, medication requirements, insulin, and the like)

Personal Information (optional)

What do you look forward to on this trip?

Are you currently involved in a church or community organization? If so, which ones?

Have you ever had a cross-cultural experience in a developing country? (i.e. ministry, travel, education)

Flight Information (if available)

If you are participating in a standard Vision Trip, please check with your trip leader before booking flights.

Arrival Date

Arrival Time

Arrival Flight #

Departure Date

Departure Time

Departure Flight #

Policies

COVID-19 Policy

Photo Policy

11.0 Media Policy and Release
11.1 By traveling with Plant With Purpose, the Undersigned consent to the recording of their likeness, image, and/or voice, and authorize Plant With Purpose to use photographs, video, and audio recordings containing their likeness, image, and/or voice in any medium for any purpose.
11.2 Ethical Storytelling Pledge: Visual media is one of the most powerful forms of communication. It can motivate, inspire, and introduce others to people and places you may have never been exposed to otherwise. It also has the power to catch a subject in an unflattering or humiliating moment. As Plant With Purpose works with some of the most marginalized peoples in the world, making sure trip participants photograph and video our global partners with respect is of utmost importance. As such, while visiting Plant With Purpose programs, staff, or partnering farmers, the Undersigned agree to taking photos and videos ethically, and specifically agrees:
11.2.1 To always ask permission to take a partnering farmer or staff member’s picture;
11.2.2 To ask the parent's permission to take the picture when a minor is involved; and
11.2.3 That all photos taken will attempt to communicate dignity, improved circumstances, and avoid participants looking vulnerable and like victims (inappropriately dressed, sick, covered in flies, etc.)
11.2.4 Additionally, the Undersigned agree to check with a Plant With Purpose staff member as to whether the partnering farmer has a pseudonym, and then only use that farmer’s first name or given pseudonym (if applicable) when sharing their story publicly
11.2.5 The Undersigned further agrees to never tag people in photographs and to avoid using specific community names when describing location (use region or country instead). GPS data on smartphones and digital cameras could potentially pinpoint the location of the individual in the image. Finally, pictures must not contain metadata that would allow someone to figure out where the image was taken (search "geotagging" for more information).

Please note that some trips require a deposit and trip payment. If applicable, please go to payment tab and make deposit.

Signature(Required)

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