Download the One-Page application form here. 

Submit form to:

Many Hands for Haiti
P.O. Box 204
Pella, IA 50219

Or email to amathes@mh4h.org at the MH4H offices.

By submitting this form, I certify that I am at least 18 years of age and competent to sign in my own name OR, if I am under 18, that I have downloaded, printed and fully completed the Permission for Travel Form (click here to download), and will mail it to Many Hands for Haiti as soon as possible. I understand that if I am under 18, my application will not be processed without this completed form.

I do hereby certify that I am willing, physically and mentally fit, and sufficiently prepared to travel with and participate in a work project with Many Hands for Haiti, in the country of Haiti. Trip sponsors have my permission to take me to a doctor for medical treatment, hospitalization, or emergency surgery if the need should arise. Should it be necessary for me to return home prematurely for medical reasons or due to disciplinary action, I will assume total responsibility for any additional costs incurred.

I also understand that there are inherent risks involved in any missions trip, and I hereby release Many Hands for Haiti, its staff and volunteers from any and all liability due to any injury, loss or damage to person or property that may occur during the course of my involvement with Many Hands for Haiti.

I have carefully read and agree to abide by the regulations/guidelines and information included in the Trip Booklet (click here to download), including the Covenant (pg 16) and the Lines We Do Not Want To Cross (pg 19). I understand that my failure to abide by those guidelines forfeits my chance to participate in future trips with Many Hands for Haiti and may result in early dismissal from any trip at my own expense.


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