"Open Wide" Independent Group Dental Service Trip to Guatemala

THANK YOU for your interest in undertaking a Dental Services Trip to Local Hope's Xela AID Complex and Eco-Guest House in the Guatemalan Highlands. Want to bring family or friends? Rest assured that there are plenty of ways that they, too, can serve and enjoy the culture.

Please set aside 30 minutes to complete this form and have your passport available. If you are registering multiple individuals, please have each group member's first and last names and an idea of the interests and talents they may wish to share during the Community Service portion of your trip, or the Optional Activities they may wish to participate in.

SERVICE AND ACTIVITIES - To see service and activity options that are available, please scroll down in this form and review "AREAS OF INTEREST" and "PAID OPTIONS and REGISTRATION."

Need help or want us to fill out this form with you over the phone? We are happy to do that. Call Mel at (714) 322-0974.

By the way: Local Hope, also known as Xela AID Partnerships for Self Reliance, is a 501 (c) 3 non-profit charitable organization federally registered in the United States, EIN #45-3658025. The organization operates in Guatemala under the auspices of Ciudades Sostenibles, a nationally registered non-profit organization, NIT 91837022. 100% of the proceeds from your contribution will fuel empowerment programs! As such, your contribution may be fully tax deductible. Please consult your tax professional.

A 9-Day 8-Night Package (which includes the add-on in Antigua or Lake Atitlán includes the following, plus transportation and most meals:

1. Pre-night stay in Guatemala City

2. Five nights (four service days) at Local Hope's Eco-Guest House at the Xela AID Complex, San Martín Chiquito

3. Transportation to Antigua or Lake Atitlán.

4. Return transportation to Guatemala City.

Should you opt for a 7-Day/6-Night package, we will return you to Guatemala City after your five nights at our Local Hope Campus.

EXTEND ON YOUR OWN?

Should you decide to extend your trip and add nights in one or more locations, here are several hotels to consider booking.

Guatemala City - HOTEL BARCELO

Antigua - HOTEL AURORA •  LA POSADA DE DON RODRIGO ANTIGUA

Lake Attitlán - LA CASA DEL MUNDO •  LA POSADA DE DON RODRIGO PANAJACHÉL

Transportation to La Aurora Airport - ADRENALINA SHUTTLES

OK. Let's Confirm Your Options and Get You Registered!

A few important notes:

1) GROUP REGISTRATION - You can register all the participants who will be comfortable in up to 12 rooms, each with 1 Queen and 1 Single bed.

2) PASSPORTS - Have your valid passport handy to enter important information we'll need (it will also prompt you to double-check your expiration date!). You will NOT need the passports of others whom you are registering. The U.S. State Department Site says: "Some countries and airlines require that your passport have at least six months of validity beyond the dates of your trip." We suggest that you follow that rule.

3) FULL PAYMENT - Full payment is required when you register yourself and your group. Refunds are available as per our policy stated later in this document.

4) YOUR PARTICIPATION MAY BE TAX DEDUCTIBLE - Please check with your tax preparer. For all payments you make, you will receive a receipt for tax purposes. If one of your trip participants prefers to receive their own receipt, please have that person register separately."

5) PAYMENT, CONFIRMATION - Please have a valid credit card ready, or you may use PayPal to complete your transaction. You will receive a confirmation copy of your application after submitting. If your credit card is "not accepted," it could be that your bank has limited your card for online transactions. You may need call your bank to OK the payment.

A - Participant Pledge - Etiquette at Local Hope's Xela AID Complex

Note: If you are registering multiple participants, you assert that you will be responsible for ensuring that everyone in your party abides by this Pledge.

1) OUTLOOK - To set a good example while in the village of San Martín Chiquito, I will bring my best to each day, including my enthusiasm, patience, a listening ear and an open heart.

2) RESPECT - I will recognize as my equal and show respect for each member of the Xela AID staff and village residents, and will strive to do so with those in my group to help ensure an outstanding service experience.

3) SEEK HELP - Should I take ill; become injured, overly anxious, frustrated or experience any other issue that interfers with my experience, I will seek the help of a Xela AID staff member to quickly resolve the issue.

4) SAFETY - I will follow safety guidelines shared with me by my Xela AID staff contact in Guatemala.

5) SUBSTANCE USE (Local Hope's Formal Policy) - To minimize risks and to avoid modeling behaviors that could be deleterious to the health and well-being of those we serve, no smoking, vaping, or use of recreational drugs is allowed on the premises of the Xela AID Complex. Additionally, in all cases and despite local jurisdictions or the law in a participant's state or country of origin, the drinking age at Xela AID Campus is 21 years of age. It will further be expected that all participants refrain from over-drinking that could result in injury to themselves or others.

B - Health - Keeping Yourself and Our Community Safe

HEALTH - If I have cold or flu symptoms during my experience, including a runny nose, fever, headache, cough, or other symptoms, to protect the staff and village community, I agree to mask, wash my hands frequently, and take related precautions and understand I may be asked by staff to do so. If asked, I will comply.

INSURANCE - Your package does not include health or trip cancelation insurance, which some guests choose to purchase. Please consider your overall health, and the likelihood of circumstances arising that could cause you to have to cancel your trip. (See our Refund Policy to further inform your decision on this option.)

In Case You'd Like to Browse or Request Specific Rooms at Our Eco Guest House

This link will take you to a page on our website where you browse our rooms. All of our rooms include one comfortable queen-size bed, and one single bed. Please make a note of the rooms you request since you'll need to match guests and rooms in the next section. If a room is unavailable, our staff will substitute, keeping guests together in the same room as you've noted. After browsing rooms, make sure to come back to finish and submit your registration(s)!

LINK TO BROWSE ROOM(S): https://xelaaid.org/eco-guest-house

NOTE: For children under 12 years old, please enter at checkout the single COUPON CODE that applies. Note that children must be accompanied by an adult:

For 1 child, enter: CU121 • 2 Children: CU122 • 3 Children = CU123 • 4 Children = CU124 • 5 Children = CU125

Refund Policy

Local Hope is a not-for-profit 501(c)(3) organization. Please note that 100% of your contribution fuels our empowerment programs! Of your total, $525 is non-refundable if your plans should change. If you believe your plans could change for any reason, we strongly advise that you purchase trip cancellation insurance.

The balance of fees paid here are refundable as follows: 100% 61 days prior to the calendar date of your arrival; 50% 31 days prior to your arrival. We regret that we cannot refund monies beginning 30 days from arrival. Exceptions: In the case of a natural disaster or travel ban imposed by the U.S. or Guatemalan government, and/or flight cancellations due to such restrictions, your trip can be rescheduled and we will offer you full credit toward your future Service Trip within two years. Thank you for your support and understanding.

TAX DEDUCTIBILITY - Please note that as a Volunteer for our non-profit organization, 100% of your contribution and expenses may be tax deductible. Please consult your tax professional. A tax receipt for the full amount contributed to Local Hope via this form and at check-out from the Eco-Guest House will be provided. We suggest you keep a copy of meal receipts, airfare, and additional hotel stays which may also be fully tax deductible.

Vaccinations and Any Medical Condition(s) You May Have - The Center for Disease Control offers guidelines for vaccinations based on international destination. Please consult the CDC here: https://wwwnc.cdc.gov/travel/

Our organization does not provide medical advice. Please consult your physician about recommended vaccinations and additional protections based on destination.

(1) PARTICIPATION - I acknowledge that my participation in this Service Trip is strictly voluntary, and further recognize the inherent risks associated with international travel. Accordingly, I agree to assume any and all risks relating to my participation. I understand and acknowledge that my participation is in the capacity of a Volunteer and that nothing contained herein or in any additional document executed in connection herewith shall be construed to create an employer-employee partnership or joint venture relationship with Local Hope or any related Third Party, either now or at any time in the future.

(2) APPROPRIATE BEHAVIOR - I will not during my visit to Local Hope's Xela AID Campus: (a) Become involved in any political movement; (b) Proselytize; (c) Give nor promise funding to any individual or organization within Local Hope's service area with whom I have no connection prior and distinct from this Service Trip; (d) Undertake these activities involving any member of Local Hope’s staff or a program participant should I return in the future; or (e) Harass or demean or make unwanted sexual advances on any staff or community member or anyone I come in contact with for the duration of my stay at the Xela AID Complex or in transit.

(3) APPROPRIATE BOUNDARIES - Should I be asked for money or passage to the United States, I will report this immediately to Local Hope's Director in Guatemala. Should I wish to help an individual or group I have met while on this Service Trip, I will work through the well-established and carefully managed program structure of the Local Hope organization (ask local Director, Deputy Director, or CEO for details).

(4) HOLD HARMLESS - I agree to hold harmless and indemnify Local Hope, Xela AID, and, if any, Third Party providers, directors, agents, employees and staff from and against any and all costs, liability, demands, claims, damage and expenses of any nature or any kind incurred in connection with my participation as a volunteer at Local Hope's Xela AID Campus or in transit. I understand that this Release of Liability is in consideration for allowing me to travel and volunteer in Guatemala in connection with Local Hope/Xela AID and but for said Release, I would not be allowed to participate.