University Ministries Spring Break Immersion Trips

REGISTRATION FOR THIS YEAR IS NOW CLOSED.
RESISTRATION WILL RE-OPEN FALL OF 2014.
THANK YOU FOR A SUCCESSFULL SPRING BREAK.


In addition to this form, please fill out the following the Risk & Release form and the Health Disclosure form.  Once completed, print them out, sign, and turn them into the Office of University Ministries. 

Risk & Release Form

Health Disclosure Form

*Forms will open in a new TAB


Trips are limited to 9 participants except for Cumberland Island, GA (limited to 6), Guatemala (limited to 5), and Apopka, FL (limited to 7).

*To pay your remaining balance due, skip the Select Destination box below, and select "Balance Due" under the Trip Payment section.




Contact Information

* Enter your full legal name as it would appear on a passport.
















Emergency Contact Information






Trip Payment


All destinations are $475, except Guatemala is $1100.
The Deposit amount is $150 for all $475 destinations, with a Balance Due of $325.
The Deposit amount for Guatemala is $300, with a Balance Due of $800.
Student Leaders only make one payment of $250.




Payment Information













Survey


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“I understand that in submitting this registration, I am entering into a contractual agreement with University Ministries, that I am responsible for paying the project fees or any expenses incurred on my behalf, should I decide to withdraw from the project. I understand that University Ministries has the right to remove me from the project should I fail to meet the expectations stated in all materials/correspondence I receive in hardcopy and/or email.”