UUCSJ Journey Registration Form

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This form is only for registering for one of UUCSJ's already scheduled journeys. If you are looking to organize a journey for your group or congregation, please contact us at info@uucsj.org.
Program Information

Registrant Information








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Birthday



Religious Affiliation




If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other

If your congregation is not listed, select other













Language Fluency












Please note that this is to give us a general sense of your ability with regards to the physical requirements of the trip. More detailed information about medical conditions, allergies, and medications will be requested upon preliminary acceptance into the program

Financial Information
The cost (including lodging, in-country flights, food, etc.) for your trip will depend on the destination and length of stay. Please refer back to the appropriate Journey page (ex: http://uucsj.org/journeys/nicaragua/) to find the specific cost of your trip.


Include child support, alimony, government assistance, etc.





Trip Requirements
Please read the following carefully and check that you understand and agree below.

1.) I understand that I am required to have had a tetanus shot within 9 years of the trip start date.
2.) I understand that UUCSJ strongly recommends that in advance of my program, I review the Center for Disease Control's immunization recommendations for my destination; and suggest that I may wish to consult a travel clinic for advice.
3.) I understand that I am required to have health insurance that covers me in the destination country for the duration of the trip (Medicaid, Medicare, and VA plans do NOT cover internationally - if one of these is your regular plan, you will need to purchase supplemental health insurance).
4.) I understand that it is my responsibility to make sure my health insurance covers the destination, and that I will provide my insurance details to UUCSJ prior to departure.
5.) I understand that I am required to have a current passport and may need to obtain a visa before the program start date for international journeys. I understand that UUCSJ can assist me with some of the information needed for the visa application, but that applying and obtaining the visa is my responsibility.