Spring Break PartnerTrip

Please enter a Username to create an account. If you already have an account please login before completing this form.
Trip Registration Information

If you have already registered and are wanting to pay your trip balance, please use this page.

Please make sure each field is completed accurately. More than once participants have submitted incorrect information which confused housing arrangements or caused other difficulties for themselves. Especially pay attention to Passport Gender and Passport Expiration, as those tend to be the most problematic. We can only work with the information you provide.

For travelers under the age of 18, a parent or guardian must complete this form.


Passport Information

Your name and other information exactly as it appears on your passport. If you are waiting for your passport to arrive, you may leave the passport number and expiration date blank and add them later.
 
Your passport must be valid during your entire length of stay in Nicaragua.

Skills and Requests

Please list any special skills you have that may be useful.
Please rate your Spanish language proficiency.
    
Check to request vegetarian meals. Other dietary requirements cannot be accommodated, so if you have food allergies or other preferences you should be prepared to supplement your food in Nicaragua.
Why can we not accommodate food allergies, sensitivities, vegans, etc.? We would like to be able to accommodate everyone's specific needs, but JustHope employs Nicaraguan cooks who are not familiar with many food sensitivities and are limited as to availability of ingredients. Rice and beans are readily available, but if you have specific dietary needs you may need to supplement your food. Please contact our office for more information.
Trip Fee
If you are paying using a credit card, please consider increasing your payment to cover the processing fee. This option adds a small percentage (3%) to your total.
Total Fee(s)
Health Information

The following fields request medical information that you may consider confidential. While our server uses an encrypted connection for webforms, the information you provide will be confirmed to you through unencrypted email to the address on your account. If you feel that you need a higher level of privacy, you might consider sending it in some other form.

List any allergies. (Separate with commas or semicolons rather than line breaks.)
List all medications that you currently take. (Separate with commas or semicolons rather than line breaks.)
List any physical limitations or concerns.
Do you have any other health concerns you would like us to know?
Emergency Contacts

Enter information for your emergency contacts. These people should not be traveling with you.



Your primary care physician
Agreements

The following agreements apply to the JustHope travel for which you are registering.

JustHope will communicate critical information to me using the email address I have provided. It is my responsibility to maintain this email address, read communication regularly, and inform JustHope if my email address changes.

Check the box below to indicate your understanding of this.

Please acknowledge your acceptance of JustHope's refund and cancellation policy below. Scroll to read the entire document, or view it here.

By participating in travel with JustHope, I give JustHope the right to use my image in photo or video and my comments for publicity purposes related directly to the mission of JustHope. I understand that I will not be given any creative control over the finished use of the images. I understand that I will not be compensated should the images or comments be used in JustHope's media pieces.

Please acknowledge your acceptance of JustHope's Ambassador and Donation policy below. Scroll to read the entire document or view it here.

Medical Release

In the unlikely event that I am unable to make medical decisions for myself, I authorize my Trip Organizer(s) (as listed on the trip information page of the JustHope website) or the JustHope staff or volunteer assigned to my group in Nicaragua, to consent to any necessary examination, anesthetic, medical diagnosis, surgery, or treatment and/or hospital care rendered to me, or to the one for whom I serve as guardian, under the general or special supervision and in the advice of any physician or surgeon licensed to practice medicine by the state and/or country in which they practice during the duration of the trip identified below.

Your name below constitutes your signature.

Parental Authorization for Treatment of a Minor Child
In the event of illness or injury, I authorize the physician and/or hospital to undertake such treatment of and perform such services for the youth as are reasonably indicated by the circumstances.

The name below constitutes the signature of a parent or guardian.

Please sign below to execute JustHope's Release and Waiver of Liability. Scroll to read the entire document or view it here.

Your name below constitutes your signature. A parent or guardian must sign for minors.