Kenya Mission Trip Application

Thank you for your interest in our short-term mission trip to Kenya.
This is a 12-day trip that includes a 2-day safari and 6 days at our schools for orphans in rural southwest Kenya.
Cost: about $3,200 including flights in January and about $4,200 for our June trip.

This includes airfare, safari, and all meals, lodging and transportation for the entire time.

Achungo has 2 primary schools and a middle schools where 820 students, orphans and destitute, are attending what are recognized as the top schools in the county. Our activities will include working in the classroom and playing with the children, teaching games, sports and tutoring as well as helping the staff and teachers. This is a full immersion experience focused on relational connection with the staff and students.

This trip will strengthen your faith, broaden your worldview and deepen your understanding of poverty. You will experience how God’s love works through community.

Contact Monte Fisher for any questions or details: montefisher@hotmail.com.

Your name *

Email address *

Which Mission Trip are you applying for *

If you attend Menlo Church, which campus? OR what other church / house of worship do you attend, if any?

Full name exactly as it appears on your passport *

What is your passport number? *

What is your passport country of issue? *

What is your passport expiration date? *

Date of birth (required for trip insurance) *

Address *

Phone number *

Emergency contact name, email, phone

How many friends/family are going with you? (Please fill out separate applications for each) *

Any special dietary needs? Any medication requirements, allergies or other health issues? *

Do you prefer a single room (there is an added cost)? *

Do you plan to get your own flight tickets (whether with miles or payment)? *

Note that if we purchase them for you through the non-profit they will be non-refundable but will be tax deductible.

Do you have a preference for your seat on the airplane?

Are you considering any side trips that will require flights other than our team flights? *

We will purchase medical trip insurance (includes medi-vac coverage). Do you also want trip cancellation insurance (about $200 more)? *

Please carefully read the waiver and release for you or your child and indicate your acceptance below.

Liability Release

I am fully and personally responsible for my own/my child’s safety and actions while and during participation and voluntarily agree to assume all the risks and responsibilities for any injury to myself/my child that I/my child may experience or incur in connection with participation in the Achungo trip and activities. I consent to any necessary medical care and treatment for me/my child in the event of injury, including, but not limited to, diagnostic studies, anesthesia, and surgical intervention. I shall be responsible related costs and expenses and will reimburse Achungo for any of these expenses paid on behalf of me/my child. On my/my child’s behalf, I hereby release, covenant not to sue, discharge, and hold harmless Achungo, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto.

Participant Waiver and Release

I/my child wishes to participate in trips and activities coordinated by Achungo Community Center (“Achungo”) and will abide by the rules and regulations governing the trip and activities and will obey any instructions given by the person(s) having supervision and control over the referenced trip and activities. I/my child will wear all recommended personal protective equipment while volunteering.

COVID-19 Liability Release

While Achungo has put in place preventative measures to reduce the spread of COVID-19, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I/my child may be exposed to or infected by COVID-19 by attending the trip and activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 on the trip or related activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Achungo volunteers, and related activity participants and their families.  I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Achungo, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in trip related activity.

Media Release

I authorize Achungo Community Center the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or video taken of ourselves to be used in and/or for any lawful promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, annual reports, websites, social networking sites and other print and digital communications, without payment or any other consideration.

Acknowledgement and Acceptance *

I understand and agree that the law of the State of California will apply to all four sections of this Waivers of Liability document. I fully acknowledge and accept all four sections of this Waivers of Liability document. I understand that I would not be allowed to participate otherwise.