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Fiji Mission Trip Registration (Free Public Medical & Dental Expo)

Thank-you for your interest in volunteering for one of our upcoming Fijian Mission Projects.

"*" indicates required fields

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Which mission trip are you interested in joining?*
Check all that might apply. The August 2025 Mission Trip is not accepting anymore submissions. If you would like to join a future mission, please select below

Contact Information

Use ONE registration form per household/mailing address. Up to five additional volunteers can register with you on this form as long as they live at the same mailing address. If they live at a different address, they will need to fill out a separate form.

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Your Name*
Preferred or Nickname

Your Mailing Address*

Your Email Address*

Do we have your permission to SMS text message you regarding the trip?
Do we have your permission to SMS text message you regarding the trip?

Emergency Contact Person*
Someone NOT traveling with you on this trip.
For example: Mother, uncle, etc.

Your Volunteer Information

Additional missionaries will be on the follow page(s).
Birthdate*
For Example: Doctor, nurse, plumber, student, etc. If retired, please note & let us know what occupation you held prior to retirement.
For example; plastic surgeon, ER nurse, elementary school teacher, plumber, etc.
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Please select your skill level for each area

There are many different skills required to have a successful mission trip. Let us know what other skills you posses.
For example; Tenor, Bass
Please describe any other skill or talent you have that might be useful on the mission. Or do you have a specific passion you would like us to know about?
You are not required to tell us any of your medical history; however, it can be important to let us know if you have any food allergies, allergies requiring the use of an epi-pen, asthma requiring the use of an inhaler, or any other circumstance that might limit your participation in the project activities. This information will remain private and only necessary leaders will be looped in.
Add First Additional Volunteer
Use ONE registration form per household/mailing address. Up to five additional volunteers can register with you on this form as long as they live at the same mailing address. If they live at a different address, they will need to fill out a separate form.
First Additional Volunteer Information*
Birthdate (First Additional)*
For Example: Doctor, nurse, plumber, student, etc. If retired, please note & let us know what occupation you held prior to retirement.
For example; plastic surgeon, ER nurse, elementary school teacher, plumber, etc.
This field is hidden when viewing the form

Please select the (First additional volunteer) skill level for each area

For example; Tenor, Bass
Please describe any other skill or talent they have that might be useful on the mission. Or do they have a specific passion they would like us to know about?
You are not required to tell us any of their medical history; however, it can be important to let us know if they have any food allergies, allergies requiring the use of an epi-pen, asthma requiring the use of an inhaler, or any other circumstance that might limit their participation in the project activities. This information will remain private and only necessary leaders will be looped in.
Add a Second Additional Volunteer
Use ONE registration form per household/mailing address. Up to five additional volunteers can register with you on this form as long as they live at the same mailing address. If they live at a different address, they will need to fill out a separate form.
Second Additional Volunteer Information*
Birthdate (Second Additional)*
For Example: Doctor, nurse, plumber, student, etc. If retired, please note & let us know what occupation you held prior to retirement.
For example; plastic surgeon, ER nurse, elementary school teacher, plumber, etc.
This field is hidden when viewing the form

Please select the (Second additional volunteer) skill level for each area

For example; Tenor, Bass
Please describe any other skill or talent they have that might be useful on the mission. Or do they have a specific passion they would like us to know about?
You are not required to tell us any of their medical history; however, it can be important to let us know if they have any food allergies, allergies requiring the use of an epi-pen, asthma requiring the use of an inhaler, or any other circumstance that might limit their participation in the project activities. This information will remain private and only necessary leaders will be looped in.
Add a Third Additional Volunteer
Use ONE registration form per household/mailing address. Up to five additional volunteers can register with you on this form as long as they live at the same mailing address. If they live at a different address, they will need to fill out a separate form.
Third Additional Volunteer Information*
Birthdate (Third Additional)*
For Example: Doctor, nurse, plumber, student, etc. If retired, please note & let us know what occupation you held prior to retirement.
For example; plastic surgeon, ER nurse, elementary school teacher, plumber, etc.
This field is hidden when viewing the form

Please select the (Third additional volunteer) skill level for each area

For example; Tenor, Bass
Please describe any other skill or talent they have that might be useful on the mission. Or do they have a specific passion they would like us to know about?
You are not required to tell us any of their medical history; however, it can be important to let us know if they have any food allergies, allergies requiring the use of an epi-pen, asthma requiring the use of an inhaler, or any other circumstance that might limit their participation in the project activities. This information will remain private and only necessary leaders will be looped in.
Add a Forth Additional Volunteer
Use ONE registration form per household/mailing address. Up to five additional volunteers can register with you on this form as long as they live at the same mailing address. If they live at a different address, they will need to fill out a separate form.
Fourth Additional Volunteer Information*
Birthdate (Fourth Additional)*
For Example: Doctor, nurse, plumber, student, etc. If retired, please note & let us know what occupation you held prior to retirement.
For example; plastic surgeon, ER nurse, elementary school teacher, plumber, etc.
This field is hidden when viewing the form

Please select the (Fourth additional volunteer) skill level for each area

For example; Tenor, Bass
Please describe any other skill or talent they have that might be useful on the mission. Or do they have a specific passion they would like us to know about?
You are not required to tell us any of their medical history; however, it can be important to let us know if they have any food allergies, allergies requiring the use of an epi-pen, asthma requiring the use of an inhaler, or any other circumstance that might limit their participation in the project activities. This information will remain private and only necessary leaders will be looped in.
Add a Fifth Additional Volunteer
Use ONE registration form per household/mailing address. Up to five additional volunteers can register with you on this form as long as they live at the same mailing address. If they live at a different address, they will need to fill out a separate form.
Fifth Additional Volunteer Information*
Birthdate (Fifth Additional)*
For Example: Doctor, nurse, plumber, student, etc. If retired, please note & let us know what occupation you held prior to retirement.
For example; plastic surgeon, ER nurse, elementary school teacher, plumber, etc.

Please select the (Fifth additional volunteer) skill level for each area

For example; Tenor, Bass
Please describe any other skill or talent they have that might be useful on the mission. Or do they have a specific passion they would like us to know about?
You are not required to tell us any of their medical history; however, it can be important to let us know if they have any food allergies, allergies requiring the use of an epi-pen, asthma requiring the use of an inhaler, or any other circumstance that might limit their participation in the project activities. This information will remain private and only necessary leaders will be looped in.

Almost Done!

Once you have completed this registration form you will be notified that your registration has been received and eventually whether or not you have been confirmed. Confirmations are based on date of registration and availability of space on the project. Medical professionals will be given priority as we cannot have free medical and dental clinics without their volunteered skills.

A fee of $350 per person/volunteer is required and includes your accommodations and two meals a day (breakfast and dinner). There is a restaurant at the hotel if you want to purchase lunch.

As a group we endeavor to fly into Nadi International Airport (NAN) together. After passing through customs we will board a chartered bus which will transport us to a local church who will supply a meal for us. Then, a three hour drive to Pacific Harbour where the accommodations, (each room accommodates 2-4 people, please tell us how many people in your party) the Yatu Lau Lagoon Hotel and Expo site are located. Transportation costs on island to be determined.

If you fly separate from the group you will need to make your own ground transportation arrangements. If you fly into Suva (SUV) then we can make arrangements to pick you up and transport you the 45 minute drive to Pacific Harbour. If you will be flying separate from the group, please send your flight itinerary to volunteer@shepcall.org (mailto:volunteer@shepcall.org) so pick up arrangements can be made.

Each volunteer working at the Health Expo site will be provided personal protection gear if needed. Medical professionals please bring your own scrubs or typical attire used when seeing patients.

Dentists, doctors and surgeons please bring headlamps for use during your procedures. The days are long and we see hundreds of patients so if your headlamps have rechargeable, swappable batteries it is very helpful.

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RELEASE AND WAIVER OF LIABILITY

RELEASE AND WAIVER OF LIABILITY

Please Read Carefully! This is a legal document that affects your legal rights.

This Release and Waiver of Liability ("Release") is executed on (today's date), by the individual whose signature appears below (the "Volunteer) in favor of Shepherd's Call Ministry, its directors, officers, employees, volunteers, and agents (collectively, “Shepherd's Call”). The Volunteer desires to work as a volunteer for various projects identified by and engage in the activities related to being a volunteer for Shepherd's Call (“Activities”). The Volunteer understands that the Activities may include constructing and rehabilitating church buildings, clerical work, and or caring for individuals who may be sick or injured. The Volunteer hereby freely, voluntarily, and without duress executes this Release and Waiver of Liability under the following terms:

Release and Waiver of Liability.

In consideration for being allowed to participate in the Activities, the Volunteer does hereby release and forever discharge, waive, covenant not to sue, and otherwise hold harmless Shepherd's Call and their successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which are related to, arise, or may hereafter arise from the Volunteer’s Activities. The Volunteer understands that this Release discharges Shepherd's Call from any liability or claim that the Volunteer may have against Shepherd's Call with respect to any emotional or mental harm or trauma, bodily injury, personal injury, illness, death, or property damage that may result from or relate to the Volunteer’s Activities, whether caused by the negligence of Shepherd's Call or their officers, directors, employees, or agents or otherwise. The Volunteer also understands that Shepherd's Call does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, workers compensation, or disability insurance in the event of injury or illness.

Medical Treatment.

The Volunteer does hereby release and forever discharge Shepherd's Call from any claim whatsoever which is related to, arises, or may hereafter arise on account of any first aid, treatment, or service rendered or not rendered in connection with the Volunteer’s Activities.

Assumption of the Risk.

The Volunteer understands that the Activities include work that may be inherently dangerous and hazardous to the Volunteers, including, but not limited to, construction, loading and unloading, and transportation to and from the work sites. The Volunteer hereby expressly and specifically assumes the risk of injury or harm in the Activities and releases Shepherd's Call from all liability for emotional or mental harm or trauma, injury, illness, death, or property damage resulting from or related to the Activities.

Insurance.

The Volunteer understands that Shepherd's Call does not carry or maintain health, medical, workers compensation or disability insurance coverage for the Volunteer. Each volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.

Photographic Release.

The Volunteer does hereby grant and convey to Shepherd's Call all right, title, and interest in any and all photographic images and video or audio recordings made by Shepherd's Call during the Volunteer’s Activities with Shepherd's Call, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

Minor Children.

The signature of a parent or guardian of a minor child on this Release shall make all provisions of this Release applicable to and binding on the minor child.

Other.

The Volunteer expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of California, and that this Release shall be governed by and interpreted in accordance with the laws of the State of California. The Volunteer agrees that in the event that any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable. By agreeing to the statements above, the Volunteer further agrees that he or she represents all the volunteers which are signed up on this form including any minors for whom he or she is responsible. IN WITNESS WHEREOF, the Volunteer has executed this Release as of the day and year first above written.

Full Name*
Sign using your initials.

Shepherd’s Call Ministry

Address: PO Box 610 Lodi, CA 95241

Office Email: Office@shepcall.com

Office Number: 505-286-5522

© 2025 Shepherd's Call Ministry. All rights reserved.
Shepherd's Call Ministry is a registered 501(c)(3) nonprofit charitable organization. All donations are tax-deductible.

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