Wesley Foundation at UNC Chapel Hill · 2023 Spring Break Puerto Rico Registration Form

Name (As it appears on the ID you will use to fly. If your middle name/initial is on your ID, list both your First and Middle Name or Initial in the "First Name" box):

*

First Name

Last Name

Birthday

*

(mm/dd/yyyy)

Email

*

Verify Email

*

Phone

*

Year

*

T-Shirt Size

*

Bunk Room

*

Women's Bunk Room

Men's Bunk Room

Do you have any Dietary Restrictions or Allergies?

*

Yes

No

Please List Your Dietary Restrictions or Allergies Here

Team Preference

Everyone going to Puerto Rico will be on one of the following teams: Fundraising (Raising Money for the Trip), Communications (Sharing the Story of Our Trip with Our Donors), Devotions (Planning a Series of Devotions to Enhance Our Spiritual Growth During the Trip), and Team Building (Helping Us Bond Before and During the Trip).

First Choice Team

*

Fundraising

Communications

Devotions

Teambuilding

Second Choice Team

*

Fundraising

Communications

Devotions

Teambuilding

Have You Ever Been on a Mission Trip Before?

*

Yes

No

Where Did You Go? When? For How Long? And What Was That Experience Like for You?

*

What Makes You Most Excited about Going on this Trip to Puerto Rico?

*

What Are You Most Hoping to Experience During this Trip?

*

Is There Anything Else We Should Know to Make this Trip the Best Possible Experience for You?

Health Insurance and Emergency Contact Info

Health Insurance Company:

*

Health Insurance Policy Number:

*

Name on Health Insurance Policy:

*

Emergency Contact Name:

*

First Name

Last Name

Emergency Contact Number:

*

Required Acknowledgments

Non-refundable Registration Fee

*

By checking this box, I acknowledge that my $100 registration fee is non-refundable.

Fundraising

*

By checking this box, I acknowledge that, in addition to my registration fee, I will work with the entire team to raise the cost of the trip, including but not limited to, participating in letter-writing, a group online giving campaign, benefit nights, The Big Wesley Auction, and other activities as directed by the Fundraising Team.

Substance Use

*

By checking this box, I acknowledge that all Wesley trips are drug and alcohol free. If you are concerned this would limit your ability to participate, please contact Campus Minister Ryan Spurrier (ryan@uncwesley.org, 919.808.6339).

How Would You Like to Pay Your Registration Fee

*

Confirm Payment Amount

*

$100

Please remember that your registration is not complete until you Venmo $100 to @UNCWesley (When you search for us, we're under the Business profile tab).

*Select $100 to confirm that you will pay $100 online to register for the Spring Break Trip to Puerto Rico

Please remember that your registration is not complete until you bring cash or check for $100 to the Wesley Building (201 E. Rosemary St--the yellow building on the corner of Rosemary and Henderson Streets).