Mission Trip Application

Thank you for taking the first step in applying to serve with us! Samaritan’s Feet uses international shoe distributions as a tool to build relationships and share the hope with people around the globe. Working with long-term, cross-cultural missionaries and national ministry leaders, Samaritan’s Feet is also involved in community development, medical clinics, and education.

1 TRIP
2 PERSONAL
3 PASSPORT
4 MINOR
5 EXPERIENCE
6 MEDICAL
7 EMERGENCY CONTACT
8 REFERENCES
9 SIGNATURE
10 DOCUMENTS

Personal Information

Passport Information

Passport information is only needed for international trips.

Minor Information

​For most trips, participants must be 16 to travel alone. If younger than 16, you must be accompanied by an adult or guardian. All persons under the age of 18 who are not traveling with both parents must submit additional documents (birth certificate and a notarized letter) and details will be provided.

I, the parent or legal guardian, give permission for my dependent to participate in Samaritan's Feet International Shoes of Hope volunteer activities.To agree to this statement, please sign using your mouse or if on a mobile device, your finger.
(Sign Here)
Clear Signature

Experience

Please check areas in which you have experience:Select all that apply

Insurance

Supplemental traveler's insurance will be provided through an outside travel insurance agency.

If I am accepted for a Samaritan's Feet project, I wish to make clear my understanding that Samaritan's Feet does not assume any responsibility for loss of property, damage to the same, personal harm or illness that may come; I, for myself, my heirs, executor, administrators, distributes and assigns, in consideration of my admission to volunteer mission projects and other good and valuable considerations, do hereby absolve said Samaritan's Feet and hold them harmless from any claim or demand which I or they might conceivably assert upon the basis of foregoing.To agree to this statement, please sign using your mouse or if on a mobile device, your finger.
(Sign Here)
Clear Signature

Medical

Emergency Contact Information

References

Please select three individuals as references. Good examples of references are a church staff member, campus minister, youth minister, co-worker, friend, someone who has observed you in a situation related to this type of trip, or someone who has observed your spiritual life/growth. Please do not list relatives or household members.

Reference #1

Reference #2

Reference #3

Final Agreement & Signature


Our Mission: Provide hope, love, and relief to suffering and impoverished children around the world, encouraging people to lead, serve and experience the life-changing power of God through whatever means possible.


Conditions of Volunteer Participation and Release from Liability: Samaritan’s Feet’s desire is to build a community of empowered volunteers dedicated to developing into servant leaders both physically and spiritually. As a volunteer, I will cooperate in the fulfillment of Samaritan’s Feet mission, while encouraging others to join in this worthwhile campaign of bringing relief to children in need around the world. Minors under the age of 16 who plan to travel without a parent or guardian must seek approval from the Samaritan’s Feet office. 


Background Certification: I certify that all of the information provided on this application is true and complete. I authorize the Samaritan’s Feet staff to investigate and verify any and all of the information I have submitted. Because Samaritan’s Feet strives to provide a safe environment for children and youth, I understand that the Samaritan’s Feet may order a criminal history check, and I authorize this investigation. Samaritan’s Feet reserves the right to deny any application due to results of background check.


Volunteer TermsI agree to abide by Samaritan’s Feet policies, procedures and Code of Conduct. I understand Samaritan’s Feet does not provide any health benefits (i.e. medical, dental, workers compensation, etc.) or any accident insurance for me as a volunteer; I understand it is my responsibility to provide this coverage. I understand that Samaritan’s Feet does not provide volunteer compensation or trade volunteer services for paid mission trips.


Property Loss: I understand Samaritan’s Feet is not responsible for my personal property lost, damaged or stolen while participating in Samaritan’s Feet volunteer activities.


Funding Overages: In the event that an individual or group raises more than the required amount for their trip, any overages will be credited as a donation to Samaritan’s Feet.


Baggage: All checked baggage will be used for bringing Samaritan’s Feet shoes and supplies into the country. All personal items must be packed in carry-on bag.


Medical Treatment: I give permission for Samaritan’s Feet representatives to provide or arrange for emergency care for me, and to arrange for transport to an emergency center for treatment. I consent to medical treatment deemed immediately necessary or advisable by a physician if I am unable to act on my own behalf. I further understand that Samaritan’s Feet is not responsible for payment for such medical treatment.


Photograph or Digital Image Permission: I give permission for Samaritan’s Feet to use, without limitation or obligation, photographs or other media that may include my image or voice to promote or interpret Samaritan’s Feet programs.


Release from Liability: I understand that accidents may occur during my volunteer activities. By signing below, I release the Samaritan’s Feet, its agents, directors, consultants, and employees from all liability based on any damage, loss or injury, whether it is the result of ordinary negligence or otherwise, caused to me or my dependent from participation as a volunteer.

I, hereby agree to the terms listed on this page including Conditions of Volunteer Participation and Release from Liability, Background Certification, Volunteer Terms, Property Loss, Baggage, Medical Treatment, Photograph or Digital Image Permission, and Release from Liability.To agree to this statement, please sign using your mouse or if on a mobile device, your finger.
(Sign Here)
Clear Signature

Additional Documents

Samaritan's Feet reserves the right to deny any applicant.

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