Building Better Lives Together  

  Quick Contact:
 

Name:*
Email:*
Message*
Enter the code shown:*
This is a CAPTCHA Image 
 
(*) Mandatory field
 

 

Global Tribe Logo

Mexico Building Trips in Partnership with Global Tribe

 

Cambodia Building Trips in Partnership with Tabitha Foundation
 

Uganda  Trips in Partnership with TEAR Fund &

Watoto

Peru Trips in conjunction with Fuller Centre of Housing

 
 Russia Trips in Partnership with Orphans Aid International

 

Visit our Facebook Page

Download our 2017 Brochure

2017 Brochure

 

 

MX1703

MX1703 Mexico Building Trip - Departs 7th October 2017

The name you use below must match the name in your passport

First Name*
Last Name*
Preferred Name
House # & Street*
Suburb
City*
Post Code
Country*
Updates are sent via email, please ensure you whitelist  

info@breakfreeexpeditions.com

Click here for assistance.
Email Address*
Home Phone
Work Phone
Cell Phone*
DOB - Day*
DOB - Month*
DOB - Year*
Gender*
Male  Female 
Occupation*
I have a valid passport*
Yes  No 

Your passport must be machine readable and be valid for 6 months after arrival back in your home country.

Passport Number (if known)
Expiry Date
reset
Nationality
Food Allergies

255 characters left
Departure Date
Saturday 7th October 2017 
Other Departure Date
Meeting Point
Departure Date from LAX
Monday 16th October 2017  Other - Specify Below 
Other Return Date
reset
Other Return Date Comments
Accommodation
Single Room (additional cost)  Share Twin 
Preferred Roommate

Click here for the Rules Regarding Border Crossing and then check the box below to indicate you have read and accepted them.

I Accept the Border Crossing Rules*

If you are coming with a group, please provide the following details (skip this if you are coming as an individual)

Group Name


I would like to apply to be a volunteer for the following positions for this trip

Van Driver
First Aid Officer
T shirt Size*

Please complete the following if you are under 18yrs otherwise skip to the next section.

Your parents will be asked to provide written parental consent for you to travel on this trip.  This is also needed for immigration authorities in the USA and Mexico.

If you are under 18 years old you must have a trip guardian appointed by your parents who will be responsible for you during the trip.

Parent/Guardian Last Name
Parent/Guardian First Name
Parent/Guardian Email
Parent/Guardian Phone
Trip Guardian Last Name
Trip Guardian First Name
Trip Guardian Email
Trip Guardian Phone


The Pre exisiting medical conditions question is a mandatory question and if left blank the form will not submit. Please indicate if you have any pre exisiting medical conditions, criminal convictions and/or communicable diseases. 

Criminal Conviction
Yes
No
Communicable Disease
Yes
No
Pre exisiting medical conditions*
Yes
No
Dates and Details

255 characters left


Please provide details of someone we can contact in an emergency.

Emergency Contact*
Phone*
Email Address


Your non refundable trip deposit of $500 is now due to secure your place.   The balance is due 1st August 2017.

I Agree*
Promotion Code (if any)
How did you find out about this trip?
By checking the "I Agree" box directly above and submitting this form I acknowledge that I have read, understand and agree to all terms, conditions and agreements contained in the agreement herein. Click here to view the Agreement.

Once you have completed this form please click SUBMIT.  You will be redirected to a payment methods page which will give you the details of where to pay your trip deposit.  If your computer shows you a blank page after you have hit submit your form has not been received by us.  Please go to Tools on your internet menu and delete your browsing history and/or temporary internet files.  Click the Trip Code on the Trips page and click the RESET button at the bottom of the form before re-completing your registration.  Please contact us if you have any problems with submitting this form.  You should receive an email from us within 48 hours confirming your trip registration.

Enter the code shown:*
This is a CAPTCHA Image 
 
(*) Mandatory field