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TEST – 2025 Path Trip Final Registration & Payment

Fill out this final registration and payment form to confirm participation in your Path trip to Belize. Every participant should fill out this form individually. If you are bringing someone who is under 18 on your trip, please fill out this form for them and check the box indicating the participant is a minor. For any questions about the form or payment, please contact Phoebe ([email protected]).

Minor?
Name(Required)
Address(Required)
Email(Required)
Do you sponsor a PathLight student?(Required)
If you have supported a student in the past or would like more information about the sponsorship process, please mention that in the “Other” section.

Trip Details

These details are important for us to ensure you have a safe and successful trip to Belize. If you do not yet have the required information (ex: flight time), please save the form and finish filling it out when you are ready.
Please include the flight number and arrival/departure time for both your flight to and from Belize.
Emergency Contact(s)(Required)
This is who we will call in case of an emergency while you are in Belize.
First Name
Last Name
Phone Number
 
Health Insurance Information(Required)
This can be your U.S. health insurance information, as long as your insurance has some sort of provision for international travel. You may also purchase travel insurance at your discretion; contact your insurance company for details about your policy.
Provider Name
Policy Number
Contact Number
Dietary Restrictions/Food Allergies(Required)
This price includes accommodation, food, ground transportation, and scheduled excursions. It does not include your flights to Belize or personal spending money. Make sure to choose the appropriate trip so the price is right for you.
If you have any questions about payment, please reach out to Phoebe ([email protected]).
Participant Agreement(Required)
PathLight International Release of Liability, Authorization for First Aid/Medical Treatment, Responsibility for Property Damage, Background Check Authorization & Publicity Permission

It is my understanding that participating in a program, recreation and other activities of the above-mentioned mission sending organization (hereinafter referred to as the “Organization”) is a privilege. Prior to my participation in such activities, I acknowledge that there are certain risks associated with the activities, including, for example, physical injury due to activity-related accidents, transportation-related accidents, and illness. In addition, I acknowledge there may be other risks inherent in these activities of which I may not be presently aware.

1. Release of Liability: By signing this liability Waiver Form, I expressly warrant that I am capable of withstanding both the physical and mental demands of the activities discussed above. I also expressly assume all risks of participating in the activities, whether such risks are known or unknown to me at this time. I further release the Organization and its leaders, employees, volunteers, and agents from any claim that I may have against them as a result of injury or illness incurred during the course of participation in the activities. This release of liability shall include, without limitation, any claims of negligence or breach of warranty. This release of liability is also intended to cover all claims that members of my family or estate, heirs, representatives, or assigns may have against the Organization or its ministers, employees, leaders, volunteers, or agents. I further agree to indemnify and hold harmless the Organization and its ministers, leaders, employees, volunteers, or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness during such activities.

2. First Aid and Emergency Medical Treatment: I recognize that there may be occasions where I may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of the Organization to seek and secure any needed medical attention or treatment for me including hospitalization if, in the agent’s opinion, such need arises. In doing so, I further agree to pay all fees and costs which arise from this action to obtain medical treatment.

3. Responsibility for Property Damage: I acknowledge that during my participation in the Organization’s activities, I may have access to and utilize property owned, leased, or rented by the Organization, including but not limited to vehicles, lodging, equipment, and facilities. I agree to exercise reasonable care in the use of such property and understand that I am responsible for any damage, loss, or excessive wear and tear caused by my negligence, recklessness, or intentional misconduct. I further agree to indemnify and reimburse the Organization for any costs incurred in repairing or replacing damaged property, including but not limited to rental cars, hotel rooms, equipment, or other facilities used during the course of my participation. This obligation extends to any fees, penalties, or expenses assessed by third parties due to my actions. By signing this agreement, I acknowledge my responsibility to uphold the Organization’s standards of conduct and to treat all property with care and respect. Failure to do so may result in financial liability and potential exclusion from further participation in Organization activities.

4. Background Check Authorization: I understand and agree that as a condition of my participation in the Organization’s programs and activities, I am required to undergo a federal, state, and county background check conducted through Checkr or a similar service. I hereby authorize the Organization to conduct such background checks and to collect and use any necessary personal information for this purpose. Furthermore, I acknowledge that I am responsible for responding to any requests for additional information from Checkr or the Organization within three (3) business days. Failure to provide the required information or to respond within the designated timeframe may result in my ineligibility to participate in the Organization’s activities. I release the Organization, its employees, volunteers, and agents from any claims, liabilities, or damages that may arise from the background check process, including but not limited to, any adverse decisions made based on the results of such checks. By signing this agreement, I affirm my understanding and consent to this background check requirement and agree to comply with all related procedures.

5. Publicity: On occasion, the Organization takes photographs or makes audio or video recordings of children and/or adults involved in church activities. Such photographs or recordings may be used by staff and participants to remember the activities and participants. In addition, such photographs and recordings may be used in the Organization’s publications, advertising material, or social media outlets to let others know about the ministry. I consent to the use of any such audio or visual record of me to be used, distributed, or displayed as agents of the Organization see fit. This consent includes but is not limited to: photographs, video and audio recordings. Furthermore, I give permission to be interviewed by the media, or for such photographs and other recordings to be used by the media.

By signing and submitting this registration, I confirm that I have read, understood, and agreed to the terms outlined above, including the Release of Liability, as pertaining to my own participation in functions, activities, special events, and field trips.
Clear Signature
By signing this form, I agree with all PathLight policies stated in the above waiver.
This field is for validation purposes and should be left unchanged.
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100% of your donation provides education and support to children in Belize. A small group of donors covers all our fundraising costs. This means every penny you donate online goes directly to helping the children and teachers of Belize.

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