TRIP APPLICATION FORM

Trip Cost: $500 per person

Name *
Name
Date of Birth *
Date of Birth
Phone *
Phone
Are you willing?
Fluent In SPANISH? *
Relation to you? *
Emergency Contact Cell *
Emergency Contact Cell
Insurance Co. Phone #
Insurance Co. Phone #
Although this is a faith-based trip, EVERYONE is welcome
Parking *
Will you be parking or leaving a car at UTSW during the trip? If Yes, please fill out the next box.
T-Shirt Size *
Trip Guidelines & Agreement *
AS A PARTICIPANT OF THE EL PASO TRIP, I AGREE TO - • Remember that I have come to serve. I may run across procedures that I think are inefficient or attitudes that I find closed-minded. I will resist the temptation to inform our hosts about how I would do things. I will be open to learning people’s methods and ideas. • Respect the trip sponsor’s view of Christianity. I recognize that Christianity has many faces throughout the world, and that the purpose of this trip is to witness and experience faith lived out in a new setting. • Do my best to keep all areas of the host building clean and free from litter. I will respect the property and grounds serving as my home for the week. I understand that any property I damage will be my personal responsibility. • Recognize that photos and videos of our experiences will be documented throughout the week, and they will be featured on some of the SCF social media sites for promotional purposes. • Develop and maintain a servant’s attitude toward the people of El Paso and my teammates. • Respect my team leader(s) and his or her decisions. • Not leave my assigned area of service or separate myself from my assigned group without first informing my clinic team leader or team physicians. • Refrain from gossip. I may be surprised at how much each person will blossom when freed from the concern that others may be passing judgment. • Respect those around me by not using obscene or abusive language or engaging in reckless behavior that could cause harm to others or myself. • Refrain from complaining. I know that travel can present numerous unexpected and undesired circumstances, but the rewards of conquering such circumstances are innumerable, and flexibility is key. • Immerse myself in the local culture, as much as possible, and abstain from making derogatory comments about local cultures and congregations, or getting involved in arguments regarding people, politics, sports, religion, race, or traditions. • With respect to the core values of SCF, please abstain from the consumption of alcoholic beverages, the use of tobacco, drugs, and smoking while on the trip. • Absolutely no weapons, knives, and firearms will be allowed on the trip, even if you possess a Concealed Handgun License (CHL)
Purpose & Goal *
Our main goal is to provide both medical & spiritual care to the underserved communities in El Paso,TX. • We understand that not everyone is Christian and we want to make sure everyone is respectful to each other. During the trip, everyone is required to attend the morning assembly meetings and devotionals. If you do not feel comfortable singing or praying, do not feel obligated to sing or pray. But if you have any questions about the Christian faith, please come and find any of the physicians or leaders and we will be happy to answer your questions. • We will also have a different speakers everyday share their thoughts on how their faith impacts them as physicians. • Often, part of meeting the patient's spiritual needs, includes praying with the patient if they request it. Students who are comfortable praying will be encouraged to pray with their patients before sending them home. If not, feel free to ask the attending physician to pray with the patient. • Please remember that it is never right to force our beliefs onto someone. But we are to say and do everything with love and grace. • It is IMPORTANT for everyone to understand, that we do NOT believe that religion or faith is a prerequisite or condition to receiving healthcare. We will not allow our faith to be an obstacle to anyone feeling welcome to be treated. We intend to see every patient with the exact same level of care and attention regardless of their interest in Christianity. Because we are a Christian organization and our faith naturally follows us into the healthcare setting, in addition to offering quality healthcare, we will also offer spiritual and guidance support to those patients who desire it.