RETURNING MEMBER APPLICATION
REQUIRED TO SUBMIT- the following will be required to submit application:
5-10 minutes to complete application
I. Personal Background
Do you have a valid passport with expiration date 6 months past your trip return date? (Ex. If your trip return date is January, your passport should be good upto July)
No, I have to renew it
I don't have a passport yet
Do you have global entry / TSA pre-check / Sentri?
I am not sure what that is
II. Contact Information
Cell Phone Number
Alternative Phone Number
Street Address Line 2
State / Province
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Cocos (Keeling) Islands
Democratic Republic of the Congo
Turkish Republic of Northern Cyprus
Papua New Guinea
Republic of the Congo
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
Tristan da Cunha
Turks and Caicos Islands
United Arab Emirates
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
III. Medical Conditions
Do you have any medical conditions that may interfere with your participation?
IV. Emergency Contact Information
Emergency Contact Phone Number
V. Trip Questions
Last trip attended or applied for? Please include Country and Year.
What trip are you applying for?
Honduras June 14-22, 2021
Congo July 20-31, 2021
Romania June 14-22, 2022
In your perspective, what traits make you a great candidate to volunteer with Christian Brigades to help achieve its mission?
I have been approved/cleared from work or school to attend the trip I am applying for.
I have not been approved/cleared from work or school to attend the trip I am applying for.
If the opportunity arises, what areas would you like to assist CB prior to it's trips? (Limit from 1-2 selections)
If the opportunity rises, what time frame would you be available to assist?
VII. Payment Plan
What is your primary plan to fund your trip?
Trip Payment - all trips are $1,750 + flight.
I would like to split my $1,750 trip fee into monthly installments.
I would like to pay the $1,750 trip fee in full.
Trip Payment Plan - How would you like to breakdown your payments?
$175/mo (10 month plan)
$292/mo (6 month plan)
$350/mo (5 month plan)
$438/mo (4 month plan)
$584/mo (3 month plan)
$875/mo (2 month plan)
$1,750/mo (1 month plan - paying in full)
VIII. Participation Agreement
VOLUNTEER PARTICIPATION AGREEMENT All Volunteers participating in any travel program of Christian Brigades, hereafter referred to as "CB", must read, intial and sign the following statement. By initialing, you are agreeing to all statements that are disclosed. Your initials serve as an agreement that fully represents your understanding of each of the statements aforementioned.
____ 1. I voluntarily and without reservation on behalf of myself, my heirs and my estate, release and discharge absolutely and forever, CB, and any of its agents or program partners, and waive all claims, demands, of whatever nature for any injury, loss, damage, accident, delay, actions or cause of action, known or unknown, which I now have or may acquire in the future, irregularity or expense arising out of or directly or indirectly relating to my participation in a CB program, and arising from the use of any vehicle or services, strikes, war, acts of terrorism, weather, sickness, quarantine, government, airline, buses, transporting company, firm, individual, or agency. I understand the terms of this release and all the consequences of it and acknowledge that I have not executed it under duress. THIS IS A RELEASE.
_____ 2. I grant CB, or any one of its agents, full authority to take whatever action they feel is warranted regarding my health and safety to arrange any medical treatment for me at my own expense, and that if deemed necessary, by CB personnel and/or local medical authorities in case of an injury. Depending on my injury, and any recommendation from the acting physician, I will be sent back to my home country, at my own expense, for any further medical treatment.
_____ 3. I will comply with all the required visas and international travel documents requested by authorities in destination and transit countries in which I travel, as well as their expiration dates. I understand that failing to have an updated passport of my local country at the time of travel, and failing to travel, due to this requirement, may result in trip cancellation at my own expense.
______ 4. I agree to purchase International Travelers Insurance required by CB which covers health and travel emergencies. I understand that failure to obtain this insurance may affect my ability to participate in this program..
_____ 5. If I cancel my trip for personal reasons or if I fail to comply with any international travel regulations (such as valid passport or entry visa to destination or transit country) and ask for a refund, I accept the following policy: all trip payments are non-refundable and non-transferable. If I wish to receive some sort of refund, I must submit a claim to the travelers insurance company.
_____ 6. I understand this is a supervised program and agree to uphold individual and group standards set forth by CB. These standards include: No nicotine or cigarette smoking of any sort while traveling with CB. No alcohol drinking or illicit drugs while traveling with CB. No on-site visits by friends/family not previously planned/authorized by CB. No leaving of premises without CB's prioir authorization. Any type of medication has to be made aware, with enough anticipation to CB staff. If any of these standards are violated, you may be removed from the CB program that you applied for, and if you are in a host country and break any of these standards, you may be removed from the CB team and returned home at your own personal expense..
______ 7. If my conduct is deemed incompatible with the interests and standards of the group and if my enrollment is TERMINATED, no refunds can be expected and returning to the United States is at my own expense. A verbal warning may be provided prior to expulsion from the program. A written report may be provided upon request. At the discretion of CB, volunteers performance may be evaluated and such evaluation will be the basis for CB response to any requests for recommendation by volunteers school, future (graduate) school/employer.
_____ 8. I understand that this is a volunteer program and an international humanitarian team effort serving the underserved in remote locations and difficult circumstances which on occasion may include basic-needs-only housing, no hot water and travel over long distances, both land and water, in safe but basic transportation.
_____ 9. I grant CB permission to reproduce photographs or movies, of me taken during the period of time that I am participating in this program, including written statements I may make concerning this program. I authorize CB to openly use any photography and/or video footage of me to promote the mission of the organization without expecting any type reward or compensation.
_____ 10. I understand and agree that if the CB trip that I have recently enrolled in is cancelled due to an emergency or for any other reason, that any and all payments that have been made to my trip will not be refunded, and I will have to submit an insurance claim to the travel insurance for a refund.
_____ 11. I understand that CB is not responsible for any damaged, stolen, or broken property, and it will be my responsibility to take care of anything that gets lost, broken or damaged.
_____ 12. I understand that all trip payments shall be submitted online at christianbrigades.org by the dates designated in my payment plan. If I do not submit my payment by the due date a $50 inconvenience fee on top of my amount due will automatically be added each time.
_____ 13. I am aware that if I book my flight without written approval from Christian Brigades, I can be dropped from the program without any reimbursement. .
_____ 14. I am aware that if I decide to cancel my participation for the designated trip all funds submitted towards trip payment and/or flight become a donation to Christian Brigades and if I want some sort of refund, I will have to submit a claim to the travelers insurance.
_____ 15. Participation Agreement: I have read and agree to abide to Christian Brigades's Volunteer Participation Agreement.
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