RAINBOW NETWORK TRIP INFORMATION FORM Trip Dates:. My Name:_____________________________________ Home Phone: ______________________ Legal name as it appears on passport:__________________________________________________ Check your Passport: It must be valid for six months after the date of return to the states. Address: __________________________________ Alternate Phone: ________________________ ( cellular, work, etc.) City: ________________________________ State: ___________________ Zip: _______________ E-mail address: ______________________________ Fax number: __________________________ Do you have a passport? Yes Not yet Please enclose a copy of your passport photo/information page. Emergency Contact Name____________________________________ Phone_________________ Relationship _____________________________ I would prefer a single room I would prefer to share a room ( double bed two beds) My roommate preference is ___________________________________________________ Have you traveled outside the U.S. before? Yes No If yes, where? Your age _________. Please list any physical conditions that the group leader should know about. (i.e. heart, stomach, exertion, heat related, bee sting, diet needs, etc.): Please list any skills/abilities that might be of particular use to the team (speak Spanish, medical training/nursing, construction, photography, etc.): Please complete this form and the Waiver of Liability form attached, along with a copy of your passport and return to: Rainbow Network 3834 South Avenue Springfield, MO 65807 Packing List for Nicaragua Suitcase We recommend 2 carry-on bags; DO NOT check any luggage. Carry-on size suitcase or athletic bag must fit carry-on regulations. American Air lists their limit as 23”X 13”X 9” (or 45” total) and a limit of 40 lb. Small lock on it. Small day pack to carry camera, notebook, snacks, water, etc. each day in Nicaragua Clothing 4 sets of clothing including what you wear for travel are sufficient for any length of trip (laundry is available if you are staying several days). No heels or ties are needed. Cap or hat for sun - small and crushable is handy. A bandanna- serves many purposes including dust mask, shade, wash cloth, etc. Bathing suit for pool at hotel, optional. P.J.s Jeans or slacks. Long, light-weight, loose. Shirts and pants will become VERY dirty. Shirts - light weight and cool, long sleeved if you need the sun protection. Shoes - leather shoes or old athletic shoes. (wear one pair, pack smaller shoes or sandals for evening) Light-weight jacket for “winter” nights or travel in Matagalpa area. (Rain jacket or a cheap poncho) Personal Items (all in small sizes) Sunscreen (sweatproof, high rating like 45) Insect repellent (highest possible deet rating). Deodorant, tooth paste, tooth brush, Small flashlight (electricity occasionally off at hotel for a while) Individually wrapped hand wipes, several travel packs of Kleenex Clock with alarm to awaken you in the morning. Shaving/cosmetic kit - no fancy scents to attract bugs. Wash cloth, (towels are provided) Medicine - personal medicine, emergency medicine you might need (bee sting, heart, etc.) malaria tablets. Cold tablet, aspirin or Tylenol, antihistamine (very dusty), eye drops (dusty and windy), Imodium and Pepto Bismo (we hope not, but prescription Cipro recommended by some doctors). Lunches and snacks You will need a lunch snack for each day in Nic. Bring dried fruit, nuts, cheese or peanut butter cracker pkgs., candy bars (Paydays, no meltable choc), Power bars, sealed pkg. Misc. Passport (good for at least 6 months after your return) Airline tickets Water bottles (1 liter or less) to carry with you. Something that will not leak in your pack Sunglasses, extra pair of glasses or contacts (very dusty and windy for contacts). Pencils or pens and small pocket-sized notebook. Camera and film. Travel tips - Be sure you have luggage tags on your carry-on and your day pack. Fanny pack may be useful. Travel wallets can be purchased to wear under your clothing, for things like passports and cash. Don’t take anything unnecessary, but take what you need. There is no place handy to buy anything when we get there. What is available, such as film is very expensive. Don’t take anything valuable or that you would hate to lose. Contact Numbers The best way for relatives to reach you for emergencies while you are in Nicaragua is to call Mark Struckhoff, either at the Rainbow Network office (417) 889-8088, by cellular 872-9748 or his home at 877-8287. Please give Mark’s numbers to the members of your group to leave with their families. Emergency contact numbers for you in Nicaragua are these: (From the US you must dial 011 505) Rainbow Network main office in Ciudad Sandino - 269-7585. Ask for Mario or Samuel, who speak English. After hours you can call Mario Bandes- cell 843-8631, where he lives at 265-8870 or his parents who speak English 532-2037. Your cellular is likely to work in Nicaragua, of course with added expense. If your group is flying from different places, it may be useful to be able to communicate in the US. You may be able to get a free or $1 cellular phone with your rental vehicle. Ask. You will have to purchase a telephone card to use it. They may sell those and install it for you. The cheapest card would give you emergency service. Realize that many rural areas do not have service. CARRY ON RULES On Tuesday, September 26, TSA adjusted the ban on liquids, gels, and aerosols. Air travelers may now carry liquids, gels and aerosols in their carry-on bag when going through security checkpoints. With certain exceptions for prescription and over-the-counter medicines, baby formula and breast milk, and other essential liquids, gels, and aerosols, the following rules apply to all liquids, gels, and aerosols you want to carry through a security checkpoint. 1. All liquids, gels and aerosols must be in three-ounce or smaller containers. Larger containers that are half-full or toothpaste tubes rolled up are not allowed. Each container must be three ounces or smaller. 2. All liquids, gels and aerosols must be placed in a single, quart-size, zip-top, clear plastic bag. Gallon size bags or bags that are not zip-top such as fold-over sandwich bags are not allowed. Each traveler can use only one, quart-size, zip-top, clear plastic bag. 3. Each traveler must remove their quart-sized plastic, zip-top bag from their carry-on and place it in a bin or on the conveyor belt for X-ray screening. X-raying separately will allow TSA security officers to more easily examine the declared items. Please keep in mind that these rules were developed after extensive research and understanding of current threats. They are intended to help air travelers bring essential toiletries and other liquids, gels and aerosols for short trips. If you need larger amounts of liquids, gels and aerosols such as toothpaste or shampoo, please place them in your luggage and check them with your airline. Make Your Trip Better Using 3-1-1 3 –1–1 for carry-ons = 3 ounce bottle or less; 1 quart-sized, clear, plastic, zip-top bag; 1 bag per passenger placed in screening bin. One-quart bag per person limits the total liquid volume each traveler can bring. 3 oz. container size is a security measure. Consolidate bottles into one bag and X-ray separately to speed screening TRAVEL INSURANCE Information for short-term travel insurance for groups working in mission: There are three agents that we have researched. You can check their website; compare their prices, deductible and coverage. We have talked with agents but have no actual experience with any of these. The cost is very reasonable. Adams & Associates. (www.aaintl.com). Cost is $2.75 per day. Paperwork is not on the website so it may be easiest to call Lindsay Ross at 1-800-922-8438. If a group then all group members must carry the insurance. Dissinger Insurance (www.dissingerinsurance.com). Cost is $2.40 per day. The enrollment can be faxed or emailed to Max Biggerstaff at email@example.com or you can call him with questions at 913 491-6385 or 1-800-386-9183 (fax 913-491-0527). eGlobalHealth has prepared a website for Rainbow Network at www.eglobalhealth.com/RBN.html Their rates vary by age from $0.90 to $6.00 per day, with a discount for a group. Direct questions to Derek Patterson at 417 882- 1413, firstname.lastname@example.org If you are affiliated with the United Methodist Church, insurance is available through the General Board of Global Ministries. The website is http;//gbgm- umc.org/vim. As you look over these different sources, you will see that the rates are very similar and the coverage is quite comprehensive. We recommend that individuals traveling with Rainbow Network to Nicaragua carry travel insurance. WAIVER OF LIABILITY COMES NOW the undersigned, and in consideration of the Rainbow Network, consenting to the undersigned traveling to its mission projects in Nicaragua, the undersigned hereby releases and discharges Rainbow Network, its directors, employees & volunteers from any claims or causes of action which might arise from any personal injury, property damage or illness occurring in Nicaragua, or during the trip to or from Nicaragua, or in preparation for said trip. The undersigned fully understands this waiver releases and discharges any claims of any kind whatsoever that might arise against the Rainbow Network, its directors, employees or volunteers. IN WITNESS WHEREOF, I have set my hand this _________ day of ____________, 200__. I have read the above and fully understand its provisions. Trip Date: Leaving ___________________ Returning__________________ ____________________________ ________________________ Signed Witness Rainbow Network recommends that you obtain “trip insurance” to help cover expenses for any emergencies that might occur during your trip. We can provide several insurance company references for your consideration.
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