Hope Trip Application

Select a Trip/Date(Required)

Full Name (as it appears on your passport)(Required)

Birthdate(Required)

Do you have a current US Passport? (If not – please apply for one now. You cannot travel to Nicaragua without one)(Required)

Street Address(Required)

City(Required)

State(Required)

Zip Code(Required)

Phone(Required)

Email(Required)

Gender(Required)

How did you hear about this trip?(Required)

Have you had previous experience on the mission field or traveled in a foreign country?(Required)

If yes, please list countries and experience

What are your expectations for this trip?(Required)

Please describe your health, including physical or dietary limitations(Required)

Are you on regular medications or currently under a doctor's care?(Required)

If yes, briefly explain

Please list any allergies (food, medicine, environment, insect, etc.)(Required)

Date of Last Tetanus (skip if you don't know)

Blood Type (skip if you don't know)

Do you speak fluent Spanish?

This trip may require strenuous physical activity for extended periods of time. Do you have any conditions (medical or otherwise) that may prevent you from fully participating?(Required)

If yes, please briefly explain

Please list any medical, First Aid, or CPR training

Please list any special talent or gifting that may be utilized on the trip

Is there anything else we should know about you?

Emergency Contact #1(Required)

Emergency Contact #1 Email(Required)

Emergency Contact #1 Phone(Required)

Emergency Contact #2(Required)

Emergency Contact #2 Email(Required)

Emergency Contact #2 Phone(Required)

Today's Date

Download Trip Waiver Here.

By signing in the below field, I acknowledge that I have carefully read, understood, and voluntarily agreed to the terms of the above waiver. I accept full responsibility for my health, safety, and well-being during this trip and release SuNica from any liability regarding my participation.(Required)

I agree

By checking this box I acknowledge and warrant that the information that I have provided on this form is true and correct to the best of my knowledge. I further agree to immediately notify SuNica of any change in the information presented. I understand that this form is valid and legally binding.(Required)

I agree

Signature