Vision Outreach - Mission Trip Application

Please take a few minutes to fill out the following information.  If you have questions of any sort, please email us at [email protected].

If you would like to be notified of future trips, choose Future Volunteer
Name (exactly as it appears on your Passport)
Date you plan to FLY TO your mission destination? (If you are not traveling with the team)
Date you plan to RETURN to your point of origination? (If you are not traveling with the team)
VOI requires and secures emergency evacuation coverage for each trip participant. The following information will assist us in securing the proper coverage.
(Please see the CDC website at . Scroll down and select the country to which you will be traveling. You are responsible for obtaining CDC recommended immunizations prior to your departure.)

By signing your FULL NAME in the SIGNATURE BOX, you agree to the following:

I am the individual listed in the form above and agree to the points below. I have read, understand and agree to the condition of this waiver, and do affirm that I am the person whose name appears in this application and have provided valid and correct information and agree to abide by its contents

I release Vision Outreach International (VOI) , its officers, trip organizers and leaders, members and team associates from responsibility for any accident, injury, sickness or death to me or any member of my family and/or loss of material items occurring as a result of any mission or training expedition. I understand and accept the personal health and safety risks involved.

I will be a guest of the host country and subject to the local laws and customs and to the policies of Vision Outreach International.

I will be working under and subject to the authority of the training Ophthalmologist or Project Director and agree to abide by his or her directives while visiting and working in the host country. I will be personally responsible for my transportation expenses, lodging, meals, and any other incidental expenses. I understand that should it be necessary for me to cancel my participation; any refunds of airfare or other prepaid services will be my responsibility.

I further give Vision Outreach International officers, expedition leaders, and other designated personnel my authorization to release pictures or stories about my participation in an expedition or training to be used in media, promotions, and websites.

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