Trip Forms

Photo courtesy of Travis Tidmore

Photo courtesy of Travis Tidmore

Before going on your trip, please take a moment to fill out the following volunteer waiver form and information form. You may either download the PDF versions and return them to your trip leader, or you can fill out the forms directly on this page. 

Volunteer Agreement and Release From Liability

Volunteer Information Form


Volunteer Agreement and Release From Liability

I understand that I will not be compensated for any time spent volunteering, nor am I entitled to benefits, including employment insurance benefits upon the termination of this agreement or as a result of this service.


I am aware that participation as a volunteer may require and is not limited to periods of riding in the back of a pick-up truck, walking on uneven terrain, digging, carrying rocks, and mixing concrete, and will require the exercise of reasonable care to avoid injury. I also realize that I could get sick from a variety of causes, including the water, food, or insects. I am voluntarily participating in this activity with knowledge of the hazards and potential dangers involved, and agree to accept any and all risks of personal injury and property damage.


As consideration for El Porvenir allowing me to participate on a work trip in Nicaragua or other El Porvenir activity, I hereby agree that I, and my assignees, heirs, guardians, and legal representatives, will not make a claim against or sue El Porvenir or its employees, agents or contractors for injury or damage resulting from the negligence, whether active or passive, or other acts, however caused, by any of its officers, employees, agents, or contractors of El Porvenir as a result of my volunteering. I HEREBY RELEASE AND DISCHARGE El Porvenir AND ITS OFFICERS, EMPLOYEES, AGENTS AND CONTRACTORS FROM ALL ACTIONS, CLAIMS, OR DEMANDS THAT I, MY HEIRS, GUARDIANS, AND LEGAL REPRESENTATIVES NOW HAVE, OR MAY HAVE IN THE FUTURE, FOR INJURY OR DAMAGE RESULTING FROM MY PARTICIPATION IN THE PROJECT.

I UNDERSTAND THAT IF I AM INJURED IN THE COURSE OF THE PROJECT, I AM NOT COVERED BY EL PORVENIR'S WORKERS’ COMPENSATION PROGRAM. I authorize El Porvenir to seek emergency medical treatment on my behalf in case of injury, accident or illness to me arising from my involvement as a volunteer. I understand that I will be responsible for medical costs incurred by such accident, illness or injury.


I understand that the materials and tools provided by El Porvenir are and remain the property of El Porvenir, and I agree to return these tools and any remaining materials to El Porvenir at the end of my volunteer service.


I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, AND SIGN IT OF MY OWN FREE WILL. I UNDERSTAND THAT SUBMITTING THIS WAIVER ONLINE IS THE EQUIVALENT OF AN ELECTRONIC SIGNATURE.

I, *
I,
Today's date *
Today's date
If volunteer is under 18 years of age, parent or guardian must read and sign the following:
If volunteer is under 18 years of age, parent or guardian must read and sign the following:
This release, its significance, and assumption of risk have been explained to and are understood by the minor.
Today's date
Today's date
 

Volunteer Information Form

Name *
Name
Mailing Address *
Mailing Address
Home Phone Number
Home Phone Number
Mobile Phone Number
Mobile Phone Number
Passport must be valid for at least six months from the date of entry.
Please include the following information: Arrival in Managua: date, time, airline, and flight number Departure from Managua: date, time, airline, and flight number
Please provide the name, telephone number, and relationship to you
Health *
We will endeavor to keep all health information confidential, but must disclose it on a need-to-know basis. This would include disclosure to the trip leaders. Do you have a current tetanus inoculation?
Please be aware that you could be up to eight hours from medical facilities that are equipped to deal with major health problems. Your safety is the most important thing, so please disclose any health information that we should know in order to keep you healthy. International travel to a hot, tropical climate is physically demanding. People with undisclosed problems or physical limitations may not be able to be cared for. Our trip leaders are not trained healthcare providers.
About You
Are you a vegetarian?
T-shirt Size
Please list any foreign countries that you have traveled to:
I speak Spanish:
If so, with whom? One bed or two?
Please include occupation, interests, etc.