Oaxaca Medical Mission Trip - June 12-19, 2026

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June 12-19, 2026

Name

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Phone

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Email

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This address will receive a confirmation email

Do you have a current passport?

*

Please select one option.

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Emergency Contact

NAME - Contact #1

*

PHONE - Contact #1

*

Choose 2-3 areas you would be willing to serve in:

Please select all that apply.

Eye Doctor Dentist Pediatrician Audiologist Medical Assistant (medical experience not required) General Practitioner or Family Medicine Physician Pharmacist Dental Hygienist Evangelism Team Member Evangelism Team Leader Team Leader Coordinator Medical Ministry Coordinator Administrative Staff/Check In Personnel Logistics Coordinator Supply Manager Crowd Control/Security Personnel Photographer/Videographer Children's Program

Cost: $150 per person deposit is due by December 31, 2025.

50% of trip cost is due by February 1, 2026
Remaining balance is due by May 1, 2026.
(Cost is not final -- but estimate the trip total to be around $1200-$1500)

DEPOSIT

Deposit ($150) Pay by check/cash (0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

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