Glory Reborn Visitor Application Form
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1. Name  *
2. Email *
3. Date of birth *
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4. Age *
5. Civil status *
6. Address *
7. Phone number (mobile/cell) *
8. Religion *
9. Emergency contact person *
10. Emergency contact phone number *
11. Relationship to you *
12. What church/school/organization do you belong to? *
13. Please indicate which dates you would prefer to come to Glory Reborn Organization in Cebu, Philippines (subject to availability). Note: November 2024 Mission Trip is OPEN for November 16-25, 2024.  *
14. Describe yourself in one word and explain why you chose that word. *
15. Have you ever been in a developing country setting or ever participated in an out of country volunteer or missions trip? Please share your experiences. *
16. Please explain why you want to come visit Glory Reborn Organization. *
17. Have you ever been around laboring women or helped someone through a birth? Have you ever seen a home birth? *
18. What would you say is your biggest strength and your biggest weakness? *
19. What do you expect from this experience in Cebu? *
20. How do you hope to help Glory Reborn Org. and its Filipino team? *
21. Please describe your religious beliefs. *
22. How do you feel about the use of family planning? (i.e. pills, IUDs, condoms, ligation) *
23. How do you feel about cold water, mosquitoes, extreme heat, and open sewers? *
24. Do you have any medical conditions that we should be aware of? Are you currently taking any medications? Please list any medications you are taking. *
25. Do you have any food allergies? Are you on a restricted diet? *
26. What is your t-shirt size? Please specify US/EU/UK etc. *
27. Please prepare a minimum of $300 to cover your food and housing during a stay at Glory Reborn of 7-8 days. A 50% deposit is required at least 2 weeks prior to your stay, and the remaining amount may be paid upon arrival in Cebu. Glory Reborn makes no profit from this payment and you may make an additional donation to the clinic to contribute to our work with marginalized mothers and babies in Cebu.  *
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28. I have read the terms and agreements and hereby agree to all of them. I have also read all of the material about the Philippines and Glory Reborn Organization and hereby acknowledge that is my, and solely my, decision to visit Glory Reborn’s clinic in Cebu City, Philippines. I understand the beliefs, values and rules of Glory Reborn Organization and hope to uphold them to my best ability while I am a guest in Cebu. I am aware that I must raise my own support for the trip and do not hold Glory Reborn Org. liable for any injury, disease, cost, bill, or any other thing incurred that I may attain while visiting their Organization. I understand that I am voluntarily coming to a developing country and I understand the possible risks to my health and my safety during my travel and stay to and in the Philippines. I do not hold the Organization, its board of directors, staff or any other personnel liable for any of these possible situations or health risks I may obtain. I also understand that this application does not guarantee my visit to Glory Reborn Organization, it is up to the discretion of the leadership and board of directors after reviewing my application. I am signing this voluntarily and willingly. *
29. Are you vaccinated for COVID-19? *
30. I understand that the COVID-19 situation in the Philippines is susceptible to change and the Philippine government may introduce mandatory hotel quarantine and/or RT-PCR testing as well as visa restrictions for foreign nationals. I understand that the visitor fee is non-refundable and will not hold Glory Reborn or its employees liable for any COVID-19 related circumstances. *
31. I understand that I must provide proof of health/medical insurance coverage for the duration of my stay at Glory Reborn in Cebu, Philippines, no later than one week prior to my arrival date. *
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