Application

General Information

Trip Month

To Country(Required)

Passport #

Date of Birth(Required)

Gender

Marital Status

Occupation

Contact Information

Primary Phone(Required)

Work Phone

Email Address(Required)

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 Flight #

Departure Date

Departure Flight #

Policies

COVID-19 Policy

COVID-19 Travel Policy, 2023

The Undersigned acknowledge and understand the contagious nature of COVID-19 and assume the risk of being exposed to or infected by COVID-19 while traveling to or participating in the vision trip. Plant With Purpose assumes no liability for any illness, disability, or death related to
contracting COVID-19.

Plant With Purpose prioritizes the health and best interests of program staff and trip participants. Consequently, while not required, we strongly recommend that Vision Trip participants be fully vaccinated and boosted at least two weeks prior to their departure, unless
medically advised otherwise.

The Undersigned further agrees to abide by Plant With Purpose’s COVID-19 mitigation measures as follows. Trip participants must:

I. Testing: Take a current COVID-19 rapid antigen test within 72 hours prior to their departure. This test must be negative to proceed with the trip.
A. For higher accuracy, we strongly recommend taking a PCR COVID-19 test prior to
departure. However, if the test is not accessible to you, please take an antigen test.
II. Masking (during travel): Abide by airline-specific requirements. We strongly recommend
wearing a mask in airports, on the airplane, and on public transit, with the exception of
eating and drinking.
III. State Advisories: Abide by any COVID-19-related regulations of the host country.
IV. Regional Advisories: Respect and follow the preferences of the local team in regard to
COVID-19 protocol and protective measures while visiting the local office, places of lodging
and dining, and partnering communities, and while in transit to and from these
locations.
A. For trip specific guidelines, please refer to
docs.google.com/document/d/14AF6CG6Emt9MslthlfX7LB1F43ix3MmcG10zFCa_zns/e
dit?usp=sharing

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)