Register Club Dust 08

Liability Form
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Please take the following steps to register for Club Dust (summer trip)

bulletType  in information and print out this form.
bulletPrint out form" Liability form" sign and date                   
bulletTotal the amount of $$ from the options above.
bulletSend check (payable to " Club Dust"), Registration Form,  and Liability Form to address
bullet**For families, please fill out a separate registration form for each person. 

**Refund Policy - Due to the cost of the trip and deposits that are required months before the trip we cannot refund your registration fee's if you signup and are not able to go on the trip.  We will send you a donation letter.

Attn:  Club Dust/summer trip

C/O  Anita Strong

231 Washburn Ave

Santa Cruz  CA 95060

 Please provide the following information:

First name
Last name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Work Phone
Home Phone
Cell  Phone
E-mail
 

Will you be boarding the Charter Bus at San Diego Airport? 

Yes______   No______

Will you be driving your auto into Mexico?

 

Yes _____   No _____

If yes, please purchase Mex. ins. before trip, see our link "Mexican Auto Ins."

Select any of the following areas that you would like to participate in:

Building Team - Homes?
Furniture Team - ? 
Under the age of 12?            /     Age of child______
Would like to participate in other activities below
Donations
Shoe giveaway
Ernie's Food Crew - food preparation
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Skilled in any of the following trades:     

Carpentry?   
Roofing?
Electrical?
Do you Speak Spanish ?  
Medical Skills?

 

 Worship Team-Do you play any musical Instruments?
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How did you hear about Club Dust?
    

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Attended past trips ?
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Will you be coming with a group, family, or individual that you would like to build with?

Yes/Name of group, family or individual you would like to build with?
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Check items below that apply:

Club Dust Trip

Before May 1st

 $180 Trip and T-Shirt

sizes S M L XL XXL
Club Dust Trip

Before June 1st

 $190 Trip and T-Shirt

sizes S M L XL XXL
Club Dust Trip

After June 2nd

 $200 Trip and T-Shirt

sizes S M L XL XXL
Children 7 to 11 $90 child sizes M L  XL
Children 6 & under $70 child sizes M L  XL
Extra T-Shirt's $10 sizes S M L XL XXL
Extra T-Shirt's for kid's $7 child sizes ML  XL

Emergency contact in the U.S.
Name
Address
City, State, zip code
Phone number

Enter today's date:

-- mm/dd/yy   Please don't forget to send in Liability form

Trip begins at San Diego Airport at 5 PM Wednesday June 25, 2008.  We will meet at Terminal 2 by American Airlines.  Look for Bayside Express charter buses. Buses will leave at 5:00 PM sharp. Trip ends Sunday noon June 29, 2008.  Buses will arrive at the San Diego Airport 1 PM.  Book your flights after 2:30 PM or later.  

Club Dust does not provide any medical coverage.  You can buy short term insurance, if you would like more information please contact the following companies:

http://www.binationalemergency.org/   Binational Emergency is a dynamic non-profit organization that will get you out of Mexico FAST in case of a medical or life-threatening emergency. Our dedicated bilingual staff will do what is necessary in arranging your safe transport back into the United States via air or ground ambulance. As soon as your call is received, we immediately assist you in obtaining proper medical care while working on your safe return to the United States. By becoming a member, we will have all the information that is needed for your safe return.

Insurance Services of America is a Christian Organization dedicated to assisting missionaries, church teams and mission organizations, who travel or live overseas, find affordable international health, life and travel insurance.       http://www.missionaryhealth.com/

STM  Services International:  They provide short term missionary coverage. Please see their web site:                                 http://www.stmservices.com

Rancho La Paloma (lodging in Mexico during Club Dust trips)

Club Dust participants can be reached at the number below in case of an emergency, in the evenings and morning hours.  Please give this number to your family. Care takers of the ranch are Mari and Nemo.

01152-665-654-232

Last revised: January 11, 2008

Liability FormClub Dust

Send mail to alicia@clubdust.org  with questions or comments about this web site.
Copyright © Club Dust
Last modified: August 06, 2007