Ecuador Trip Registration
PREREQUISITES and REQUIREMENTS FOR THIS TRIP:
1. Prior to completing this registration you MUST read the following detailed documents at www.CampBethelVirginia.org/Ecuador
 - DETAILED TRIP ITINERARY
 - ECUADOR TRAVEL INFORMATION

2. Prior to completing this registration you should have made (at minimum) your initial $800 deposit, $300 of which is non-refundable AT ANY TIME, and the remaining $500 is non-refundable after July 22.  Payment button is at www.CampBethelVirginia.org/Ecuador.

Upon SUBMITTING this Registration Form, Trip Leader Beth Wiegandt will contact you about the trip, and she will send you a required Participant Health Form. Beth's email is YourOutdoorClassroom@gmail.com.

Required information is marked with a red "*" asterisk.

Sign in to Google to save your progress. Learn more
Email *
Participant Authorization and Assumption of Risk Form: Do you agree to the Participant Authorization as described below? *
I have read all the trip information contained in the documents "DETAILED ITINERARY," "ECUADOR TRAVEL INFO", and I understand and agree to all the information therein. I understand that I will be participating in physical activities (including, but not limited to those listed in the trip descriptions) and the potential for accidents or illness exists. In consideration of acceptance into this trip. I indemnify and hold harmless Camp Bethel, the Virlina District Board–Church of the Brethren, Inc. and its staff, volunteers and officers from any and all liability, claims, damage, injury or illness sustained by me. I verify that the information on this Registration Form is correct and complete as far as I know. The information on this form may be printed and copied for camp records. I agree to the release of any records necessary for emergency purposes. I agree to read all information included in confirmation materials sent to me after registration and to share this information with my emergency contact person, and to return any and all applicable forms and information. I permit photos, video and audio of activities or interviews that may include me to be used in camp/trip promotion without liability or remuneration.
Required
Your First Name *
Thank you for using correct capitalization throughout this form.  Required info.
Your Last Name *
Thank you for using correct capitalization throughout this form.  Required info.
Your Gender *
On this trip, our accommodations are gender binary. 
Your Date of Birth *
Ex: 02/09/1981.  Required info.
Your Full Mailing Address *
Include Street or PO Box #, City, State and Zip.  Thank you for using correct capitalization throughout this form.  Required info.
Your Cell Phone Number *
We will use this number to communicate trip specifics and/or important updates about our time together.  Required info.
Do you understand what your $3,250 fee does NOT include? *
I understand my trip fee does NOT include the following: Flight to and from Ecuador (arrive September 22; depart AFTER 2:00 pm on October 6). Meals not stated on the itinerary. Alcohol purchases with meals/other. Additional snacks, drinks, or incidentals. Gratuity for drivers, and guides. Personal purchases. Information is included in the document, "Ecuador Trip Info" (located at www.CampBethelVirginia.org/Ecuador)
Required
Do you understand what IS included in your $3,250 fee? *
I have read the document, "2023 Ecuador Trip Info" (located at www.CampBethelVirginia.org/Ecuador) and I understand what IS included in my fee.
Required
Do you understand the deposit amounts, deposit dates, and the refund policy? *
Total cost is $3,250 per person:  $800 deposit is due ASAP and by July 15, of which $300 is non-refundable at any time and the remaining $500 of your deposit is non-refundable after July 22.  $2,450 balance is due August 20.  All deposits and payments count toward your total fee. NOTE: $300 of your $800 initial deposit is non-refundable at any time, and the remaining $500 is non-refundable after July 22.  NO REFUNDS AFTER JULY 22. (Trip insurance is strongly recommended.)  If Camp Bethel cancels this trip, then all fees and deposits will be refunded.
Required
Have you considered purchasing Trip Insurance from your preferred insurance carrier? (Recommended but not required.)
BECAUSE $300 of your deposit is nonrefundable at any time, and that THERE ARE NO REFUNDS AFTER JULY 22, 2023, TRIP INSURANCE IS STRONGLY RECOMMENDED.
Do you understand that this international trip requires a passport valid through at least April 2024? *
Required
BE SURE TO CLICK THE "SUBMIT" BUTTON BELOW.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms