Peru Project Tour Registration & Deposit

Project tour dates: October 1-7, 2024

Please plan flights through Jorge Chavéz International Airport

Arrival in Lima: by 5:00 PM in local time on October 1, 2024

Departure from Lima: any time of day on October 8, 2024

Travel to new places is always stressful on your body, and travel to developing countries can be especially taxing. Health care may not be easy to access in areas we are visiting. For these reasons, it is important that you carefully consider the state of your health and make sure you carry the medications you may need (along with a photocopy of the prescriptions) and ONLY drink water that has been bottled or treated (including in drinks, ice, and brushing your teeth).  Also, make sure that your immunizations are up-to-date.  Again, please refer to a Travel Clinic/Tropical Disease specialist and the Center for Disease Control for specific country information: (https://wwwnc.cdc.gov/travel/)

Please fill in all information clearly and completely – keep in mind the Health Form is designed to give Green Empowerment the information needed to adequately respond should you require healthcare.  To reiterate, we strongly recommend you complete a health check-up both before and after your program participation.

Please indicate prior/on-going health issues that may affect you during this program (back pain, diabetes, allergies, epilepsy, prior knee or ankle injuries, heart issues, stomach illness, headaches, history of stroke, anxiety, etc.). Explain what medications and treatment are necessary. Describe any allergic reactions or other side effects to medication. Are you presently under a doctor's care for this concern? 

I answered all health questions in good faith and have not withheld any relevant information that may assist my caregivers. I consent, and give permission, to Green Empowerment and its partner representative to communicate relevant information concerning my health -- to pertinent health and insurance professionals -- should I need medical attention and the situation warrants them acting on my behalf:

1. I have voluntarily enrolled in Green Empowerment’s program. I understand that travel to any new place, especially in a developing region, may involve changes in plans, unexpected delays, and limited access to some services. I understand that I am subject to the laws of the country we are visiting, including those of Immigration and Customs –and-- that Green Empowerment cannot be held accountable for the actions of governments or their representatives. I am aware that the use of transportation, housing, food, and other goods and services or activities in connection with participation in the program carries a risk of personal injury and property damage or loss.

2. I release and discharge Green Empowerment, its officers, directors, employees, and legal representatives from liability or injury, damage or loss arising out of the arrangement or provision of transportation, housing, food, and any other services or goods involved in the tour. I agree not to sue or make a claim against Green Empowerment or any cosponsoring organization and its officers, employees, directors and legal representatives for any liability, damage, or loss incurred during or in connection with the Green Empowerment program that I have been involved with. I do not release the above-mentioned parties from liability for willful or intentional acts.

3. I understand that payment for the trip is NON-REFUNDABLE unless Green Empowerment itself cancels the trip. I agree to Green Empowerment’s right to cancel the trip or to cancel my participation in the trip, under reasonable circumstances, at any time as long as all money I have paid to Green Empowerment is refunded to me.

4. I have read the enclosed “Code of Conduct for Participation with Green Empowerment” and understand that by participating in a socially responsible Green Empowerment Tour, I agree to act in a respectful manner. I understand that if I break this agreement I will receive 2 warnings, and if the same behavior continues I will be asked to leave the group at my own expense.

• Not to consume any illegal substances
• Not to transport or purchase any weapons of any kind
• Not to be violent or participate in any violent act or activity
• Not to act in a way that will put others or me in danger.
• Not to participate in any type of sex trade in the country I will be visiting

• Limit my daily alcohol intake so as not to impair judgment and/or profoundly impact my ability to function as a responsible group member
• Be responsible for my own personal belongings and not expect others to watch over my things.
• Set enough time for me to rest every night so that I may be fully energized, ready, awake, and alert for the following days activities. If I feel the need to rest or do an alternative activity, I will ask Green Empowerment to provide the opportunity for rest or an alternative activity.
• Not use language or speak in a manner that is rude, offensive, or aggressive.
• Be flexible, as I understand that I am not in my home, and that not everything will go as I may want, or as according to plan all the time.
• Communicate my own interests to them but I will not be demanding. The Facilitator has the whole group to care for and thus cannot cater to every person’s individual and divergent desires. 
• Understand that my program facilitators are often activists, organizers, educators or professionals in their home communities. I will treat them with respect and recognize they are committed to a vibrant enriching experience for the whole group. 
• Adhere to the itinerary and scheduled departure and meeting times. If I am sick or need to rest, I agree to communicate with my Facilitator as soon as I become aware of an illness or a need for more rest.
• Not leave the group for any reason without an expressed written agreement outlining the timeframe and scope agreed upon between the lead Green Empowerment staff in-charge and me.

• Be aware and respectful in the way I take photographs.
• Ask ahead of time if it is okay to take pictures
• Understand that in some cultures picture-taking can be invasive and will seek permission, when possible, to take someone’s photo
• Be conscious of how disruptive it can be to constantly take photos during a meeting and/or while someone is speaking