Register for a Trip2017-06-02T12:27:05-07:00

Registration is simple and easy. If you have a heart for kids and you don’t mind giving a week of your life, then we would love to have you! We promise you won’t regret coming!

  • Personal Information

  • Terms of Release: I hereby give my permission for myself and/or a minor under my legal guardianship to participate in an activity organized by LifeChange Action. I hereby release, hold harmless and absolve LifeChange Action, Inc., their staff, sponsors, vendors and all others who have participated in the planning, organizing, and implementing of the activity, be they individuals or organizations, singly or collectively, from responsibility and liability for any illness, injury, misadventure, harm, loss or inconvenience suffered or sustained as a result of the participation in the activity. I understand that in the event I require medical treatment while engaged in the activity, reasonable efforts will be made to contact my designated emergency contacts; however, if they cannot be reached, I hereby consent and give my permission to the LifeChange Action staff or any adult volunteer acting on behalf of LifeChange Action with respect to the activity, to consent to any X-ray examination, medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state and/or country where the services are rendered, either as an outpatient or in any hospital. To the best of my knowledge, I will provide a list of all my medical allergies, medications being taken, medical problems and other pertinent information before my arrival for a mission trip/activity. Finally, I agree that LifeChange Action may film, tape, or photograph me or my voice during my participation in the activity. I agree that LifeChange Action will be able to use them, in whole or in part, whether in original or modified form in any manner or media, including without limitation, for the purpose of advertising, promoting, and publicizing LifeChange Action, whether during the activity or thereafter. I hereby release and discharge LifeChange and all affiliated entities from any and all claims, demands, or causes of action that I have in connection with the use and exercise of the rights granted in this release.

  • Confirmation

  • By clicking the submit button below, I agree that all information is accurate.

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