You may complete the Trip Application Form in two ways:
 
 
 
1. Fill in the text boxes (below) and click the SUBMIT button.
2. Download a printable version in PDF form by clicking here.
 
 
 
 
Background Information
 
Today's Date
Trip Dates
 
Please enter information below as it appears
exactly on your passport:
 
Name
Phone
Address
City/State/Zip
Sex
 
Date of Birth
Marital Status
Occupation
Mother's Maiden Name
 
Passport Number   Passport Expiration Date
 
Contact In Case Of Emergency
Name   Relationship
 
Address   City/State/Zip
 
Phone   Email
 
Additional Questions
How many times have you traveled from the US to Cuba?
When was the last time you went to Cuba?
Under what license?
What is your reason for traveling to Cuba?
Release of Liability and Approval of Ministry
If I am accepted, I will:
  • Adhere to all of the instructions and guidelines provided by ECHO-Cuba regarding my trip, including the delivery of humanitarian aid to specified locations;
  • Keep a copy of my travel documents (i.e., flight ticket, authorization letter, etc.) for 5 years, should the author-ities make an investigation;
  • Be responsible and prompt with all stated financial aspects related to my trip;
  • Participate in filling out a post trip report for ECHO-Cuba;
  • Wholeheartedly cooperate with ECHO-Cuba staff, per-sonnel and representatives in the U.S. as well as Cuba.
In consideration for being accepted and allowed to participate in this project, and activities associated with its programs and locations, I personally assume responsibility for my actions, and release ECHO-Cuba and any associated groups or ministries, their board members, employees, and missionaries from loss, injury, or damage to myself or my property; provided that nothing contained herein shall excuse ECHO-Cuba and any asso-ciated groups or ministries, their board members, employees, and missionaries from the responsibility to act with reasonable care for the safety of myself or my property.
Typing your full name in this box constitutes your electronic signature:
Signed
Date
 
 
 
 
 
 
 
 
 
 
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