Santa Cruz, CA mi68sendme@gmail.com

Summer 2024 Registration

Trip dates are June 19-24, 2024
Please register each person in your party/family separately

Early registration deadline ($50 discount) is May 31, 2024. Registrations after May 31 pay full $450 registration fee ($250 for children under 12).
(Registrants after May 31, 2024 may not receive their tee shirt until after the trip is over.)

Name *

First

Last

Email *

Confirm Email

Gender *

Age *

Adult (20 or over)
Teen
Child 6-12 years
Child (Under age 6)

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone

Group/Church Affiliation

Emergency Contact *

First

Last

Emergency Contact Relation

Emergency contact phone number

Tee Shirt Size and Style *

Men's
Women's
Youth

Medical Needs, please explain.

If you have medical needs, do you require an electrical outlet?

Yes
No
Not Sure

Special Dietary Needs, please explain. (The ranch kitchen will have some vegetarian options.)

Any food allergies? If so, what are they?

What are your travel plans to and from Mexico? *

I will need transportation from San Diego Airport that leaves by 4pm and back from the Ranch on Monday, 6/24.
Drive own vehicle to/from Mexico (not recommended for first timers)
Other (please note below)

Other mode of transportation

If flying to the San Diego Airport, please provide the following: airline, flight number, city of origin, scheduled arrival time.

Preference to room with family or friends (list all names, we will try our best to accommodate)

If staying elsewhere, please list where:

Do you have medical skills? If so, are you willing to be identified as such during the trip?

Are you fluent in Spanish? If so, are you willing to be identified as such during the trip? *

No
Yes, but don't wish to be identified
Yes, I am willing to be identified during this trip

Skill Level for Building *

None (I don't know what a hammer is!)
Limited (I can paint and pound nails)
Intermediate (I have some experience building)
Advanced (I have operated power tools)

Building experience? Please explain. *

Preference – choose one or more

We will do our best to accommodate your preferences.

Registration Fee per person *

Adult
Child under 12

Register each person in your party separately. Early registration deadline ($50 discount) is May 31, 2024. Registrations after May 31 pay full $450 registration fee ($250 for children under 12). (Registrants after May 31, 2024 may receive their tee shirt at a later date after the trip is over.)

Sponsor another to join our trip (optional)

General donation (optional)

Donation towards a house – optional (each house with latrine costs $13,000)

Total

$ 0.00

Terms and Agreements *

I have read and agree to the Waiver and Release of Liability listed below *

Waiver and Release of Liability —
The undersigned (the "Volunteer"), desiring to participate in the activities/programs, and ministries promoted and/or facilitated by or through Mission i6:8 Inc., hereby agrees to assume any and all liability for the Volunteer's acts or omissions in the course of the activity participated in by the Volunteer, and further relieves Mission i6:8 Inc., its officers, Board of Directors, agents, and any and all other persons associated with or operating through Mission i6:8, Inc. of any and all liability for loss, damages, death or injuries occurring in the Continental United or outside of the Continental United States, and agrees to indemnify and hold Mission i6:8 Inc., its officers, Board of Directors, and agents harmless for any and all loss, damages, death or injuries which may be caused by the Volunteer in the course of participating in activities sponsored, promoted, or participated in by Mission i6:8 Inc. The Volunteer understands that these waivers and releases herein cover each and every member of the Volunteer's family and_ that the Volunteer's agreement in these waivers and releases is a precondition to the Volunteer's participation in activities sponsored, promoted, or participated in by Mission i6:8 Inc.
The Volunteer hereby warrants that he/she is of full age and has every right to enter into this release in his/her own name in the above regard. The Volunteer states further that he/she has read the above release and agreement, prior to its execution, and he/she is fully familiar with the contents thereof.
IN CONSIDERATION OF being permitted to participate in Mission i6:8 trips, the Volunteer, on behalf of myself and my heirs, executors, administrators and assigns, has executed this agreement.
If minor under 18 years of age I hereby give permission for the participant listed on the registration form to participate in the Mission i6:8 trip to Mexico organized by Mission i6:8 for the dates listed on the registration form.
I give permission to any of the Mission i6:8 leaders to act on my behalf concerning any medical emergency involving my child until I can be notified by reasonable means.
By checking the box on the registration form, I agree to the terms and conditions in this waiver and release of liability.

Signature *

If applicant is a minor, sign by a parent or guardian

Note: Please check that all your information is correct before submitting.

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Summer 2024 Registration

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