Restoring Hope InternationalLaying Foundations for Faith, Family and Future

Name *


Address *


Phone *


Email Address *


Date of Birth (Month/Day/Year) *


Marital Status *
Single Married Engaged Seperated Divorced Widowed

Do you have a passport? *
Yes No

Name on Passport


Passport Number


Date of Issue (Month/Day/Year)


Expiration Date (Month/Day/Year)


How did you hear about Restoring Hope? *


Have you served with RHI before? *
Yes No

When and how long would you like to stay at Restoring Hope Village?


In what area would you like to primarily focus your voluntary efforts? *
Child care Special Needs Child Care Bible studies, Counseling, Discipleship Community outreach Construction

Why do you want to visit Restoring Hope Village? *


Travel Companions or Team Name (if any)


Please list any allergies or special dietary requirements (if any)


Please list any history of serious physical illness or surgeries (if any)


Do you suffer from any mental disorders or illnesses *
Yes No

Have you ever been accused of physical or sexual abuse? *
Yes No

If yes, please explain


Is there anything in your personal history that would call into question your ability to work with children? *
No Yes

If yes, please explain


Do you have a history with excessive alcohol use or illegal drugs? *
Yes No

If yes, please explain


Have you ever been convicted of a misdemeanor or a felony? *
Yes No

If Yes, please explain


Is there anything that you need to share with the RHI staff that may affect your service with RHI?
Yes No

Please enter your Church's information, Church Name, Pastor's name, Phone number, Address, if you do not attend church leave blank


Please list two individuals not related to you that will provide a refrence for you. Please include email address, phone number, and physical address. Please indicate the nature of your relationship with this individual. *


Second reference


Please enter emergency contact information (home phone, cell phone ,email) *


TEAM MEMBER AGREEMENT Assumption of Risk and Waiver: I understand and accept the risks of my visit to South Africa and The Village. I accept responsibility for myself and my possessions. Release and Hold Harmless: I agree to release and hold Restoring Hope International, Restoring Hope Trust, The Village, and all staff, officers harmless for any illness, injury, death, personal and/or property damage, property theft, or other loss incurred. Code of Conduct: I have read and understand The Village Code of Conduct (see link at the top of this page). I agree to abide by it. In addition, I agree to follow instructions given by RHI field staff. I understand that violation of this, or any behavior deemed unsuitable by the Operations Manager could lead to termination of my visit at The Village. Policies & Procedures: I agree with the policies and procedures of RHI, RHT, and The Village. I am in agreement with the goals of this ministry and my words and conduct will support the spirit of the work. Certification: I have read this entire Agreement. I understand it and agree to abide by it. *
I have read and agree to the terms above I have read and I do not agree with the terms above I have not read the terms so I don't know if I agree or not

Please enter full name. First, middle, last. *