Traveler Information Form

This is part 1 of a 6 part form. Please leave around 20 minutes to fill out all the forms.

  1. Traveler Information Form
  2. Medical Release Form
  3. Waiver of Liability Policy
  4. Photo/Video Release Form
  5. Code of Conduct Form
  6. Informational Travel Documents

Your Full Name (as appears on passport)

Date of Birth

Passport Number

Date of Issue

Date of Expiration


Home airport preference

Airline frequent flyer mile number:


Seat assignment preference

* Please note: We will do our best to accommodate your preference. During peak travel seasons (summer, holiday), we may not be able to select seat assignments, and you will need to do so online after you receive your e-ticket info or when you check in to travel (up to 24 hours in advance).

Traveler Flight Location
I am traveling from the East Coast of the USI am traveling from outside the East Coast of the US

Flight Options for Travelers Outside East Coast
For travelers from locations outside the East Coast of the US: The most economical option for flights for those traveling from outside the East Coast often includes red-eye flights. If you do not want to fly overnight, we can arrange a hotel stay (usually in Miami or Atlanta) the night before your team flies into Port-au-Prince. This would extend your trip dates by 1-2 days and increase the cost (hotel costs are not covered by your trip fees).

*If you need to return home by a certain time, it is your responsibility to let us know *before* we purchase your airfare. Once flights are purchased, any changes made will be at your own expense. We will do our best to accommodate you; however, based on a variety of factors, this may not be possible. Although we want you to be personally happy with your itinerary, our first priority is to make sure that the needs of the whole team are met. Thank you for your understanding in this.

The following section is optional.

Name of Home Church:

Church website:

Church Phone:

Name of pastor:

Are you connected to any organizations or people (i.e., sponsored children) in Haiti? Please list.

* We will do our best to help you visit those that are in and around the Port-au-Prince area. However, connections are not always possible due to factors outside of our control.

Do you have any special skills or training that may benefit the team (sewing, handyman, etc.)?

T-Shirt size
or other size

T-Shirt cut
(*Ladies sizes run 2 sizes smaller than the unisex cut, on average)