Please list any restrictions (physical limitations, allergies) you may have and medicines you are currently taking.  (If none, please indicate such.)

I understand that Mission of Hope International will provide meals for me daily, according to their pre-established menu selection and that they do NOT provide individualized menus based on dietary allergies, restrictions, or choices.  I also understand that there may not be opportunity or availability to purchase special items while staying in Luperòn.  I agree, therefore, to bring my own nonperishable foods to supplement the prepared meals.

Please follow this link to read the Accident Waiver and Release of Liability Form.  Respond to agree or disagree in the box below.

The cost to stay at the mission (bed, meals, safe water, in-country transportation, and scheduled activities) for 7 nights is $895.  A $100 deposit is required to complete the application process.  This deposit will be used toward preparations for your arrival and is non-refundable.