Information and Leaders
Guide
The Village Mountain Mission Project
An adventure with a mission in the Third World
Updated March 24, 2013
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TABLE OF CONTENTS
About the Village Mountain Mission: Vision, Mission, Methods . . . . . . . . . . . . . . . . . .
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What you will be doing: your group, project, schedule, day at beach, carnival . . . . . . .
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Housing and living arrangements: living arrangements, food, communication . . . . . . .
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Travel: destination, timing, costs, parental permission, documents, gear, preparation .
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Health and safety: medical facilities, exams, medication, safety . . . . . . . . . . . . . . . . .
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Finance and Fund Raising: cost, payments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
What you should know about Dominican Republic: location, history, climate,
economy, government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Other topics: Third-world, poverty, personal equipment, dress, religious services,
music, money, trash, language, memories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Forms Needed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Appendix
Fund Raising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Recommended Gear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gifts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
First Aid Kit Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Maintaining Sanitary Eating Utensils / General Sanitation . . . . . . . . . . . . . . . . . . . . . .
Medical Preparation for DR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hurricane Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Suggested English / Spanish Vocabulary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial Responsibility Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Parental Permission form (in English and in Spanish) . . . . . . . . . . . . . . . . . . . . . . . . .
Code of Conduct and Waiver of Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Map of Luperon, DR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Map of region around Luperon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Updated March 24, 2013
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THE VILLAGE MOUNTAIN MISSION PROJECT
An adventure with a “mission” in the Third World
ABOUT THE VILLAGE MOUNTAIN MISSION
"The Village" Mountain Mission Project is a program whose focus is to provide assistance for
families of the Third World. “The Village” is a hands-on, non-profit organization created to generate
high adventure mission trips for groups who desire close, personal involvement and want a less
expensive experience that can make a lasting difference to others. It has been in development since
2000 and has been the dream of Director Bill Benson, retired Director of Operations, Florida Sea
Base, Boy Scouts of America.
Welcome to “The Village.” We are sure your participation will be a life changing experience for you
and for others too! We welcome youth and adults to participate.
Vision
The Village Mountain Mission (VMM) is an instrument of change to improve the quality of life in the
Dominican Republic (DR).
Mission
With our hearts and our hands we will fill long-unmet needs of children and families in the villages of
the Dominican Republic while providing a life-changing experience to those who serve with us. In
doing so, we look to foster a relationship between the two cultures.
Methods
The project provides plenty of fun and High Adventure for our young people to reward their hard
work, while they learn about the Third World. We visit remote mountain villages, where the wealthy
never go, and tourists are rare.
In most third-world countries, individual families must rely on support from the greater family or their
community at large. Where unemployment is high, even that help is minimal as is aid from outside
organizations. A small nation of limited natural resources and technology like DR is not able to
provide the assistance similar to that which we are accustomed. Housing can be poor. Education is
limited and expensive, so poor families have children that are at risk. Medical aid is available, but
may be difficult to reach.
It is our intent to concentrate the effort of a group of people over eight days to assist the poor. Most
groups will repair or replace the home of a poor, sick, or elderly family, who physically, financially, or
otherwise cannot do so for itself and leave the family with as cool, dry, and secure a shelter as
possible. Some groups will do other aspects of our work, including medical/dental assistance,
providing clean water, or working with our C.A.R.E. Program. We will focus on mountain villages in
the Luperón area of the Puerto Plata province, where the need is great.
WHAT YOU WILL BE DOING
a. Your group
Our target group size is 8 to 18 people to simplify work planning and supply, but we have
accommodated different sizes. Small groups may be combined to make a large work crew. Large
groups may work on more than one job site. Our goal is to bring as many youth as possible, but we
also work with adult groups. The minimum age is 13 by your arrival. In all cases, there must be a
minimum of two adults per group.
b. Our project
Most groups will work in construction. At “The Village” we build houses made of concrete blocks
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with a cement floor and a corrugated roof. Construction materials, plans, and tools will all be
provided. It helps if each group has someone with minimal construction experience, however a staff
member will be assigned to each work group that can provide needed direction. See link to
separate Construction Manual at www.villagemountainmission.org and go to page “Taking the trip”.
There may also be opportunities for serving with our school or working in our medical efforts.
Discuss details for these options with the VMM Director at villagemountainission@yahoo.com
c. Activity schedule – high adventure plus our project
Your schedule will have a basic framework of a day to get comfortable, about four days of work, and
the remainder to relax and have fun. Your timetable will be flexible to cater to each group's activity
preferences (e.g. swimming, visiting a church built with materials from Christopher Columbus’s first
church, visiting the Columbus National Park, going on a multi-tier waterfall excursion, and so on)
and the availability of building supplies and support help. We will keep an eye on the weather, which
could alter our plans. You also may choose to do extra work for the village or at our VMM
compound, as you see the need.
d. Fun in the water
One of the big events is the waterfall excursion. Your guides will help you climb 7 tiers of a beautiful
27-tier waterfall. You will then use nature’s water slides to get down. Water shoes or "tennis shoes"
are REQUIRED for the waterfall trip; flip-flops are not permitted. Someone in your group may also
wish to have a waterproof camera for both the waterfall and beach day.
You will also spend leisure time on a beautiful, isolated, Atlantic Ocean beach. Your water shoes
from the waterfall are strongly suggested for your time on the beach. Abrasive live coral and razor
sharp coral rock are common. There are also many spiney sea urchins on the beaches. These
spines will ruin the rest of your week, if you step on them. Each group must provide their own water
safety program on the beach; there are no lifeguards in these secluded beaches. Waves rolling in
from the open ocean can be quite tiring. It is easy for swimmers to exceed their own “safe limit”. You
will have time to swim and snorkel. Swimmers should always be in pairs. If you wish to snorkel,
bring your own gear, which should include an inflatable snorkel vest.
e. Village Carnival
Most groups desire to interact with the villagers, so we developed the concept of each group
running a small carnival. The carnival should contain 4 to 10 independent events to involve people
of all ages and should run for 1.5 to 2 hours. The main intent is to involve the children, but many
adults will attend also.
 Encourage active events that can be run by 1-2 people with few Spanish-language skills.
 You need to plan for and bring inexpensive prizes for everyone, including adults. Plan for at least
80 participants, with 30% adults of all ages.
 Bring all needed materials. Do not assume that you can get anything, except native material
(sticks, water, etc.) that you will need to bring to the site.
 Develop events to run in any weather, although hot-dry is normal. Wind could be strong.
 Expect that participants understanding and following instructions would be the exception and not
the norm; build this into your planning.
 You need someone in authority to supervise prizes to ensure equal distribution.
 Remember, keep it simple. Relays generally do not work well. Language can be a barrier.
Ideas for carnival events
Here are some ideas to consider, but plan others so that the carnival does not become stale: face or
arm painting (e.g. tempera paint), make necklaces and bracelets from beads, marble games, make
bubbles – big and small, make and fly paper airplanes, balloon games – air or water filled, everyone
helps make chalk drawings, simple games (such as for very small children) such as duck, duck,
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goose (or pato, pato, ganso in Spanish), coloring book projects, make or apply decals, ring toss or
bucket toss games, etc. Refer to children’s game books for other ideas.
HOUSING AND LIVING ARRANGEMENTS
a. Our living arrangements
Your base camp will be an outdoor shelter at the VMM compound, which is located between El
Estrecho and Vuelta Larga, near Luperón. The shelter will have racks where you will hang your
hammock for sleeping. Most shelters will have a shower, but none have electricity.
b. Food and cooking
All of your food will be prepared for you, but you will be involved in setting up and cleaning up. You
will be provided local foods that are NOT supermarket, fast-food variety. For example, cooking from
scratch in the DR could start with a live chicken -- something you may not have seen camping in the
USA. Meals may include fresh fruits that you have never seen before. But, when you eat a freshly
picked pineapple for the first time, you will find out how good it can be. Food will either be brought
to your shelter or you will eat at our dining area/kitchen complex. Food for lunch will be brought to
your work site.
c. Communication
The Dominican Republic has the best phone system in the Caribbean, owned and operated by
Verizon, based in Miami. Our understanding is that some US cell phones may work in the DR; check
with your provider before you go. Project staff will have cell phone access to interact with family or
family physicians, as needed.
TRAVEL AND PREPARATION
a. Destination, timetable, and costs
Your destination is Luperón, in the northern province of Puerto Plata. You must fly into Puerto Plata
International Airport or into Santiago, both an hour (+) ride to Luperón. The whole group needs to
arrive at the same airport within a few hours of each other. Our project representative will meet you
at the airport. Travel to Luperón is by local transportation (arranged by “the Village”). You should
schedule your flight to arrive as early as possible on your first day (preferably by early afternoon)
and depart as late as possible the afternoon of your last day (e.g. after 1 PM). Your group is
responsible for arranging your flight and tickets; this cost is not part of your fee. Airfare tends to
cost $400 to $800 depending on departure city and early booking. Early reservations and group
purchases are very helpful; ticketing delays can be costly.
b. Parental permission (check)
A minor (under 18) traveling without parents in the DR must have a notarized parental permission.
Two signatures are required, even if one of the parents is traveling with the youth. Leaders should
carry these forms. The parental permission form is attached.
c. Documentation and going through customs
 All persons traveling outside the US will need a passport. Bring waterproof cover to protect your
passport. Crew leader should carry photocopy of first page of all passports in crew.
 Get tour cards at the Luperón airport before you go through Customs. Tour cards cost $10; this
cost is not covered by VMM fees.
 Always be ready to show your goodwill, even if you encounter less-than-friendly Customs Officers
in both the US and the DR. Their job is stressful, and they take their job seriously.
d. Tour permit
Boy Scout-affiliated groups should complete a BSA National Tour Permit, which must be obtained
from their local council prior to departure. Members of other organizations should find out if their
organization has a similar requirement.
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e. Recommended gear
See Appendix.
f. Hat
We have a distinctive project hat that makes your group instantly recognizable to the locals, and
they help in maintaining group integrity when traveling. We highly recommend purchasing these
hats; please contact us for information. Hats must be purchased before leaving the US, as they are
not available at the site.
g. Preparation
Your adventure will include swimming, outdoor living, and the mission project. We recommend
participants acclimatize themselves to prolonged stays in warm, humid weather. Other conditioning
may be needed for some individuals. The group should review and practice water safety plans and
must provide all needed supervision during beach activities. It will help if each construction group
provides some training for participants on how to mix mortar and lay block, but we do train on-site.
HEALTH AND SAFETY
a. Medical facilities
As with any outdoor activity, whether it is high adventure or just a kickball game, there is risk of an
accident. First, we are within an hour of the best hospitals in the country. Santiago, the wealthiest of
all the cities in the DR, is 45 miles from Luperón and about 30 miles from our compound. Luperón
has several pharmacies; these provide many medications over the counter that would be
prescription medications in the US. There is also a (24-hour) free clinic in Luperón that we have
used. We can also communicate with medical experts in the US and the DR (see Communication).
b. Medical exams, immunizations, medication
It is our recommendation that every one attending should have a current medical exam. Everyone
in the group should review and discuss special conditions noted. The exam form should provide
enough information for the crew leader to understand medical issues and allow the participant’s
physician to provide cautionary comments as appropriate. This form is only for the group’s use and
not for the project. Group leaders need a copy of all physical forms and must be prepared to handle
all special needs. A form such as the Boy Scout Annual Health and Medical Record may be used.
Crew leaders should maintain contact information of health insurance coverage for each participant
(provider, policy number, and phone number). If one of your participants has special medical
issues, please make us aware of their situation.
For your safety, participants should have current immunizations for tetanus, typhoid, and Hepatitis
A. All participants may want to consider preventative medication for malaria, but it should be noted
that some people have side effects to such medication. Consult your family physician about this
treatment.
c. Montezuma's Revenge (Diarrhea)
Stomach upsets are possible due to our body’s reactions to what we eat and drink. To minimize
this, bottled water is provided by VMM for consumption and we oversee production of our food. The
good news is that there are preventative medicines available if something still happens (Peptobismol, Imodium, and Cipro).
d. Safety in the DR
Participants may be concerned about their safety when in foreign countries. While the Village
Mountain Mission Project takes great care to ensure the safety of all participants, it is not possible to
provide absolute guarantees. But one way of judging the safety of an area is to look at statistics on
worldwide violent crime.
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As parents, we feel that sending our children to locales close to us in the USA (e.g. Canada or
Mexico) is reasonably safe, while areas that we are not as familiar with and farther away (like the
Dominican Republic) would be less safe. However published data indicates that the DR is
statistically much safer than Mexico, Canada, or the USA in general. The list below shows the
relative level of violent crime per capita by country, taken from a worldwide summary of the 62
countries with the highest crime rates. The Dominican Republic was not in the top 62. Noted
countries are: Mexico (6), United States (24), Canada (44), and Switzerland (56).
Data is from www.nationmaster.com/graph-T/cri-mur-cap. Data was taken from Seventh United
Nations Survey of Crime and Operation of Criminal Justice Systems for 1998-2000.
FINANCE AND FUND RAISING
Costs and payments
1. See the web site (http://villagemountainmission.org/?page_id=331) for cost per person. Stated
cost does not including airfare or $10 tour card, but does cover all costs from arrival to departure,
including local transportation.
2. See Appendix for thoughts on Fund Raising.
3. Details of the payment schedule are to be worked with Village Mountain Mission treasurer.
Contact the treasurer at VMMtreasurer@gmail.com for mailing address.
 A $450.00 nonrefundable deposit reserves your eight-day time slot.
 Complete the Reservation Request Form and the Financial Responsibility Form and return with
your deposit. Deposits and registration forms may be submitted to the Village Mountain Mission
Director or representative during a presentation or contact the treasurer at
VMMtreasurer@gmail.com
 The VMM treasurer will acknowledge your deposit with a letter and/or email with your special
Crew Account Number. All future payments must have this Account Number to insure proper
credit. A Crew is responsible for collecting and tracking money from individual participants. The
VMM treasurer will begin monthly billing based on your estimated number of participants.
Fluctuations of 2-3 participants are not unusual throughout the billing period. Changes can be
made to your count up to 30 days prior to your departure. Your “30 Day Out” billing statement
will reflect your final number of participants and cannot be changed. Send monthly checks to
the VMM treasurer in the amount due, clearly marked with the Crew Account Number. No
refunds are given less than 30 days prior to departure.
 Within 30 days, the group needs to be current with the payment schedule. It is the responsibility
of the group to keep track of all payments and send one check to the VMM Treasurer.
 It is recommended that the crew leader require a $100 deposit per participant to hold a spot on
the crew and then require regular payment to crew leader, so that funds will be available to
make crew payments.
 Fees are due in 4 equal payments at 4, 3, 2, and 1 month out from departure. Notify the
treasurer immediately if a change in number of participants occurs. You need to make up the
difference on the next payment.
 Return a copy of the completed Group Roster at the time of the last payment. Electronic copies
are highly encouraged.
 By 30 days prior to arrival, a final count of participants must be provided and all fees for the
group must be paid, in full. Arriving on site with more people than registered can result in major
problems and restrictions on the whole crew. Outstanding balances will be collected by the
VMM staff member at the time of your arrival and before any activities are begun.
 A late fee of 5% per month will be assessed for all fees not paid on time.
Payment plan
Payment plan: Total due = # participants X total fee.
Deposit due upon booking = $450
Payments = {Total due - $450 deposit} ÷ 4
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Balance due 30 days prior to departure
Number of payments and payment amounts may change depending on number of months prior to
departure. Contact the Treasurer with questions and for information related to your adventure.
WHAT YOU SHOULD KNOW ABOUT THE DOMINICAN REPUBLIC.
a. Location and size
The Dominican Republic (DR) occupies the eastern two-thirds of the island of Hispaniola, the
second largest island in the Caribbean. Formerly a colony of Spain, DR shares the island with
Creole-French speaking Haiti. It is part of the Greater Antilles, surrounded by Jamaica, Puerto Rico,
and Cuba. The island nation is approximately the size of West Virginia. DR is one time zone east of
US Eastern time, but during the summer the clock is the same as Eastern Time zone (no Daylight
Savings Time). Since we are just a few degrees off the equator, expect it to be dark by 6 PM.
b. The land
We work on the north coast in the province of Puerto Plata. The Cordillera Central mountain range
is within the province. The mountains rise steadily from sea level to 4,000 feet, and then plummet to
the floor of Cibao Valley. Further inland the mountains reach 10,000 feet. The villages we will
serve are on the north slope and most access is by crude mountain roads and paths only.
c. History
Arawak and Carib Indians settled Hispaniola about 3,000 years ago, traveling in dugout canoes
from South America. The western portion of the island evolved into a more highly developed Indian
culture known as Tainos. The arrival of Columbus in 1492 brought a dramatic change. The Spanish
search for gold introduced European diseases; plagues of influenza, small pox, and measles killed
90% of the natives. France colonized western Hispaniola, and Spain the eastern part of the island.
The western end later became Haiti, and the east became the Dominican Republic (DR). The DR
gained independence from Haiti in 1844. There was much chaos in governing itself, so the US
became heavily involved to protect and stabilize the new Dominican Republic. Today, both the
government and the people of the DR appreciate and encourage American participation.
d. Climate and weather
As with all western Caribbean countries, the DR is in the tropics. On average, the daytime
temperature in the summer is 80-85°F, while falling only 4-5°F at night. In the mountains, the
temperature will vary more and be somewhat cooler. During the day, the temperature can climb
quite substantially, especially while people are working in the sun. In the fall, winter, and spring,
temperatures can be 10-15˚F cooler and it tends to be humid, lesser so in the mountains. A
pleasant phenomenon is the land-sea breezes. Along with trade winds, the ever-present breeze
blows inland during the day, but at night it reverses and the cool mountain air pushes the warmer,
humid air out to sea. Rain patterns are more complicated; the DR has two rainy seasons: spring
and autumn.
e. The economy
Unfortunately, the economy remains weak. There is hope that technical training is in the future; a
small entrepreneurial class is growing. Sugar cane remains the largest export, although those
employed receive very low wages and are primarily Haitian. Tourism is growing (20% of GNP), but
those employed receive low wages. Unemployment remains as high as 85% in the rural villages.
Women tend to find more work than men do, so the men tend to work away from the villages. The
most common form of work in the Luperón area is working in agriculture and dairy. Some families
have cattle, both for meat and milk, and cheese is a major local business. For a large number of
families, the day-to-day task is finding food and water.
f. The people
The Dominican Republic is home to more than eight million people. Many are very poor, but the
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people are a warm, friendly, and humble people. As anywhere, the people in the cities are less
friendly, but in the villages, people are kind and hospitable. While traveling, even in large cities, if
you appear even a little friendly, they will look after you as if you were a lost child.
In the village you will be held in high honor and will be a curiosity to children, as few strangers stray
to remote areas. If they sense you are a friend, they will invite you into their home, however humble.
The family may be poor by our standards, but they will offer you food and gifts from their meager
store. It is a true joy to help such people and to take a sincere interest in learning their culture.
g. The government
The Dominican Republic is a representative democracy with 29 provinces. The military represents
about 1.5% of the total population versus 5.7% in the US. During the island's history of democracy,
the head of state has served for long periods. However, recent elections have brought new people
to office, so political stability may be improving.
OTHER TOPICS
a. Third-world culture and poverty
Most people on their first visit to a third-world country are in for a serious culture shock. This is
normal, and we consider the experience a perfect setting for teenagers to grow a greater sensitivity
toward others. Guided exposure to sanitation issues and rural community living, limited private and
government resources, and hands-on experience with catastrophic hardship involving entire villages
will aid young men and women in formulating a more realistic view of the world we share. You will
find that, faced with adversity, the Dominican people approach life with a smile. Smile back and
they will open their homes and hearts to you.
It will become quickly evident that needs are great. You will be tempted to give them anything you
have, including money. A few villagers may ask for donations, but please do not give handouts. We
don't want to turn them into beggars. You will make our future efforts almost impossible, if you do
so. We can do so much more for them than a few pesos can buy. Some things you can bring will
be of benefit; see Appendix. We hire villagers to help in some ways, so they earn what we give
them. Please do not tip.
Humility is a real virtue here. The natives may not understand a word of what you are saying, but
shouting or boisterous behavior is not appropriate.
b. Electronics, personal CD players, and similar equipment.
 Each group should set its own policy, but our recommendation is to “leave them at home”.
 Our intent is to let participants experience a Third World environment. CD’s and similar
equipment are not a good fit and will help insulate us from our surroundings.
 Having such equipment can emphasize the difference between the rich (“gringos”) and the poor
(the natives); that is a distinction that we do not need to emphasize. The natives are honest, but
very poor. Do not put temptation in their way by displaying expensive electronic equipment.
 Storage space for such items is minimal; people must carry what they bring the whole way.
 Time spent working on your Spanish will yield a much more enjoyable experience.
 Environmental conditions are harsh on electronics and can cause permanent damage.
Electricity for charging electronics is extremely limited.
c. Appropriate dress. Our intent is to make a good impression.
 Please don’t insult people with poorly chosen clothing (e.g. rock band T-shirts with suggestive
comments, lewd artwork, etc.). If you would not feel comfortable wearing such “slogans and
artwork” to church with your grandmother, then leave those clothes items at home.
 Dress conservatively. We are guests in a culture that does not dress the way we do at home.
We have not set a dress policy, but we offer the following as guidance.
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“The manner of dress should not threaten the health, welfare, and safety of participants. Any
form of dress could be an issue if it attracts undue attention. Shirts and tops should have a high
enough neckline and pants should have high-enough waistline to cover all cleavage. Examples
of inappropriate apparel include, but are not limited to, halters, midriff tops, strapless tops,
revealing and/or see-through tops, garments with open sides that expose skin or muscle tops,
and low-riding pants. Form-fitting shorts should not be worn unless completely covered.”
Travel clothing. Shirts, T-shirts, and hats representing your organization build pride in
your members and gain recognition from those you meet. We strongly encourage
wearing the project hat as this identifies participants and can prevent problems.
Clothing during building phase
o Wear appropriate clothing for construction in hot, sunny climate.
o Close-toed shoes, gloves, hats, safety glasses, etc. should be worn. Boots are
helpful for hiking to work and protecting feet during construction.
Beach apparel guidelines
o Male should wear swimsuits at the waist.
o Females should wear suits with appropriate coverage and have a cover-up of some
sort for extended periods of time out of the water.
o Appropriate lotions or clothing to provide protection from sunburn and insect bites
should be considered for all phases.
d. Religious Services.
We encourage participation in this part of the island culture, as religious activities are important
there. The poorest of the natives will attend in the finest clothes that they have. We suggest that we
not insult them by showing up in rags and needing a bath.
e. Music
Dominicans love their music: Merengue and Bachata are typical. They play it loud or not at all, any
time, anywhere. We do mean loud, so get used to it.
f. Cash, purchases, dollars and pesos
You will have little need for money during your visit except for $10.00 for your tour card. We
recommend taking about $50-100 per person and possibly (ONLY) one credit card per group (Visa
and Master Card may be taken, Discover is generally not accepted) and/or an ATM card, however
ATMs are unreliable.
Marked prices in DR will normally be $xx, but that means DR pesos, not $US, so confirm the cost.
We suggest buying souvenirs (if desired) in Luperón and not at the airport. You can convert dollars
to pesos at the Verizon office in Luperón or the local money exchange cheaper than at the airport.
The exchange rate may fluctuate in the mid-30’s pesos for one dollar. A souvenir could cost 300800 pesos, or a meal “in town” costs 150-300. In a small village store, snacks are typically 5 or 10
pesos, and that is a reasonable price.
Confirm expected costs and then haggle. Street vendors will often set prices higher for Americans
unless prices are marked. When buying a souvenir, ask vendor to write the price on a piece of
paper, then haggle for a price 25% to 50% less! A storekeeper may ask 600 pesos for a wooden
statue that he will sell for 400 pesos. Stop, look, ask the price, put the item down, and walk away.
Come back later, and either make an offer or let them make an offer to you. Be polite and don't
rush; vendors will respect you for it. Prices at the airport are high, and vendors will not haggle.
g. The Language (Spanish)
The Dominican Republic is a Spanish-speaking country. While the Dominicans understand some
English in tourist areas, most do not where we will be traveling. If you can learn 60 – 100 basic
words, you can do very well. If you make an effort to speak and understand even a small part of
their language, they will appreciate it. See Appendix for a suggested basic vocabulary.
Updated March 24, 2013
10
h. Memories of your visit
We all take memories with us when we leave; we also try to leave some memories. We leave
memories of us with the villagers, both with the work we do and by being involved with them. We
ask each group to plan a short carnival (about 2 hours) with the villagers. We also encourage each
group to paint their logo on our shelters. Please bring paintbrushes (see Recommended Gear) and
be ready to buy a small amount of paint in town. Please design and paint an area of wall about 2
feet high and 2.5 feet wide (this could be logo, names, memories, etc.).
FORMS NEEDED
Reservation Request Form (on web site)
Financial Responsibility form (attached)
Parent Permission form for youth under 18 years of age (attached 2 pages English and Spanish)
Village Mountain Mission Code of Conduct and Waiver of Claims (attached)
Group Roster (on web site)
Information and Leaders Guide (on web site)
Construction Manual (on web site)
A health form of your choice
“THE VILLAGE” MOUNTAIN MISSION PROJECT
For more information, visit our website at www.villagemountainmission.org or contact us at
The Village Mountain Mission Project
R. R. #1, P. O. Box 631, Sugar Grove, Ohio 43155, USA
Send e-mail to villagemountainmission@yahoo.com
From the USA, phone 740-318-4538
Updated March 24, 2013
11
APPENDIX
FUND RAISING
Some participants may find it difficult to pay the full cost out of their own pockets. Here are some
concepts you might consider to reduce this cost.
 Historically our biggest success in this area comes from personal request letters made to
members of extended family. In this we suggest that you explain the need for financial aid to
fund a mission trip and explain value to both the Dominicans and the attendees. See sample
fund raising letter below as a guide. Best results come from your indicating that you would
appreciate whatever they can give and that they might share this request with their church or
club and request a small donation for you. For best results we recommend a minimum of 30
letters.
 Many groups will actively support people going on mission trips. Consider making presentations
to churches, civic organizations, or veterans groups to gain their support. Show the value to the
people in the Dominican Republic and explain what your trip could do to promote understanding
and the importance of such a mission trip. Most organizations will make donations for such a
worthy cause. Photos are available electronically to enhance your presentation. Members of
uniformed groups should go in uniform.
The following are thoughts you might want to include in a fund-raising presentation about your
mission trip. Who are we? Where are we going? What will we be doing? Why are we doing it?
What is the village like? What are the families like? How long will we be there? How will we get
there? How many are going? How much money do we need to raise?
 Develop a group fund raising project. But in each case, emphasize the “mission” aspect of the
trip, showing value to others.
Example of a fund raising letter – for family member.
Hello Aunt Helen,
We hope all is well for you in Florida. It's really cold up here in Ohio brrrrrrrr. Mom tells me you just
had a hip replacement.....ouch. How are you doing with that?
I wanted to tell you about a wonderful opportunity I have. I've decided to go on a Mission trip with my
youth group. We're going to the Dominican Republic to help build a home for one of the poorest
families in a remote village. Can you believe it.....cool huh !
However I could use a little help. With airfare the whole trip will cost about $1,300. Do you think you
could help me with the funding for this? Maybe your church could help; any amount would be really
appreciated.
Many Thanks. Mom says hi. With much Love, Allison
*Please give "Fluffy" a big hug for me!
Updated March 24, 2013
12
RECOMMENDED GEAR
Daypack
Handkerchief / neckerchief
Duffle bag (not suitcase)
Sunglasses
Sheet / light blanket in summer, heavy blanket
Wet wipes
otherwise
Work gloves
Hammock with mosquito netting *
Sunscreen (at least SPF15), include lip
Eating kit
protection
Water bottle(s)-wide mouth, heavy wall
Insect repellent
Comfortable walking shoes, flip-flops
Personal toiletries
Sneakers that will get wet (ocean, waterfall)
Clothes pins, laundry bag
Underwear (~8 pairs), T-shirts (~6)
Rope, wire, heavy twine (polyester, nylon, etc.)
Heavy socks (~5 pairs)
Pen and paper
Shorts
Flashlight and extra batteries
Jeans or long pants for evenings
Camera and extra film, disposable waterproof
Appropriate clothes for church (if desired)
camera (for ocean and waterfall)
Ball cap; a wide brim hat could help
Passport
Swimsuit, towel
Money –$50 - $100
A crank/solar emergency power source with USB port for charging cameras and electronics
Prescription glasses if using contacts
Please consider donating the majority of your clothing when you return for distribution by the project.
 Campmor catalog has a large variety of hammocks with range of price, such as provided by Byer
and Bliss, costs at $40 and up. Spray all hammocks with permethrin before traveling. If you are
considering to do this type of mission more than once, consider a higher quality hammock like
Hennessy Hammock’s Expedition model*, expensive at $159 (includes rain fly – others don’t have
this). You enter through a velcro-lined opening in the bottom, rather than crawl in from overhead
as in others. Hennesey (www.hennessyhammock.com) offers group discounts for mission
projects. Add 2 pieces of 6-8 foot rope and 2 climbing-rated carabineers for hanging in diverse
conditions.
Group Gear
First aid kit with appropriate medication (see attached for suggestions)
Electrolyte source to counter-act heat exhaustion (e.g. powdered Gatorade or equivalent)
Rope, wire, twine, duct-tape
Sewing Kit with needles and safety pins
Several boxes of “wet wipes” or equivalent,
*Toilet paper or prepare to purchase in DR
2 bottles of anti-bacterial hand sanitizer
Gifts for local helpers (see attachment #2)
*Eating utensils (frisbie–plate and eating utensils)
Some campstools or fold-up chairs are useful
Carabineers of various sizes to hang gear
A few sets of goggles and snorkel equipment to use on beach is helpful, but bulky
Paint brushes: one medium and several small plus small tubes of paint to decorate logo on shelter
Extra trowels, cement working tools (particularly for large groups), 3’-level, string level, 2 hand saws
Small Spanish dictionary may help.
Updated March 24, 2013
13
GIFTS
As mentioned, you will want to give the village and families everything possible. However
handing out too much, especially money, could create serious problems for future groups.
Your best gift is to restore a home, giving 20 more years of use to a family. Giving 5 or 10
pesos will only create beggars from the ‘wealthy white man’ (gringo in the local vernacular).
However, small gifts of value can be given that may have more lasting value. The trick is to
have enough for each age group and gender: men, women, boys, and girls. Our
suggestion is for each group to bring 4 “nice” gifts for men and for women and then an
assortment of general gifts (see below). A “nice” gift could include comb/brush/mirror set,
necklace or bracelet, scarf, kitchen utensil, pocketknife, multi-tool or small tool set.
One of our major interests is providing support for the local schools; we currently donate
materials to 6 different schools. We are the main source of supplies for these rural schools
where often times they struggle to prepare themselves adequately. Anything that you can
do to bring school supplies would be greatly appreciated.
Here are some examples of general gifts:
School supplies
Crayons (8-pack)
2 composition notebooks
5 Pens, 5 pencils
1 pencil sharpener
Request 10 packets per
participant
Paper, high-lighters (optional)
Caulk, erasers (optional)
Gifts for children
Marbles, tennis balls
Hair ribbon, hair ties,
Mirrors, small combs/brushes,
Neckerchief for head)
Baseball hats-professional
team
Beads, hemp cord/string
Gifts for adults
Fishing line, hooks
Needles, thread, scissors
Toothbrushes, tooth paste
Flip-flops (all ages)
Files, pliers (all types)
Pocket knives
Cooking supplies
Curtains, sheets, towels
You can box up the gifts separately from your personal gear so that we can transport the gifts for
you, once you arrive.
Please consider bringing a FEW extra items of children’s clothing, underwear and shoes for
distribution. Also consider donating your usable, dirty clothing when you leave.
Updated March 24, 2013
14
FIRST AID KIT BASICS
These thoughts for a 2-part first aid kit come from a multiple-trip attendee with first aid background.
 The smaller kit can be put into a daypack and carried at all times. It contains basics for common
ailments and injuries. Additional items can be transferred to it from the larger kit when activities
dictate, such as the tenderizer on Beach Day. A small, soft-sided toiletries kit with zippers,
pockets, and elastic bands was perfect for storing the necessary items.
 The larger first aid kit has two purposes. It contains some duplicate supplies to restock the
smaller kit. It also contains supplies that are used less frequently, but may be necessary for
ongoing care. Common illnesses and injuries on the Village Mountain Mission Project include:
small cuts and scrapes, cactus (mija) exposure, bites and stings, dust and debris in eyes, burns,
heat related illness, blisters on hands and feet, and sore muscles.
We had Cipro (Rx) for use with Imodium should someone experience diarrhea and vomiting from
suspected food-poisoning. I suggest Permethrin (OTC) to treat mite bites. These chigger-like
insects seem to plague some people more than others, while bug spray and mosquito netting had
little or no effect on prevention. Our treatment during our trip was frequent application of Benadryl
and hydrocortisone creams after showers to reduce itching and inflammation.
I suggest keeping blister-pack medication and dressing items in Ziploc bags as moisture is a
problem. Small zip bags can be bought at Michael’s Craft Store (jewelry/bead aisle). Use blank
address labels or a marker to simplify identification. A silver Sharpie marker will write on dark fabric
to label hidden pockets. The alternative to protecting your first aid kit is to place it into a single
larger Ziploc bag.
First Aid Kit, Travel Size: (I used a 5x7x2” toiletries kit to keep these items. Refill as needed from
the larger Camp First Aid Kit.)
*Waterless Hand Sanitizer
*Small bar soap
*Wash cloth
*Latex gloves
*Pre-moistened towelettes
*Alcohol prep pads
*Assorted band-aids
*Mole skin
*Tweezers
*Tylenol or Advil
*Claritin or similar allergy medication
*Tums or Rolaids
*Benadryl pills
*Pocket knife (scissors multi-tool)
*Eye wash / drops
*Gatorade or similar electrolyte powdered mix.
*Creams: Hydrocortisone 1%-Benadryl 2%, Benzocaine lotion or similar, Triple antibiotic
*Whistle
*small flashlight
Camp First Aid Kit (I used a large toiletries kit 8x10x3” to store these items.)
*Tylenol or Advil
*Burn cover pads
*Bonine (for nausea)
*Tums or Rolaids
*Benadryl pills
*Swimmer’s ear drops
*Sudafed
*Imodium
*Zantac (reduces stomach acid)
*Alka-seltzer
*Pepto-Bismol
*Fiber pills or Metamucil
*Soap
*Latex gloves
*Alcohol prep pads
*Orajel
*Roller bandage 2” wide
*Multi-tool with scissors
*Sports cream or liniment
*Matches
*Dental Wax
*4x4” and 2x2” gauze pads
*Glasses repair kit
*Kleenex
*Blue Ice – aloe gel with lidocaine (or equivalent)
*Claritin or similar allergy medication *Cipro (antibiotic Rx associated with food poisoning)
*Permethrin cream (Rx for treatment of mites on the skin)
*Additional Benadryl cream, Hydrocortisone cream, and antibiotic cream as needed
*Unseasoned Meat Tenderizer (for stings from bees and sea urchins)
*Self adhering stretch “veterinarian” wrapping tape (substitutes for Ace wrap and gauze tape
because it withstands the dirt, humidity, and high activity level.)
*Tincture of Benzoin (OTC) is useful to help bandages adhere better in humid conditions.
Updated March 24, 2013
15
MAINTAINING SANITARY EATING UTENSILS / GENERAL SANITATION
The recommended approach to ensure that eating utensils are sanitary is to use disposable plates,
cups, and cutlery. However some people want to re-use permanent utensils. We have used three
methods to sanitize dishes. The choice is up to the group and what they may choose to do with
sanitization water afterwards. These sanitizing solutions are also good to sanitize surfaces that
need it: table, shower floor, and seat in banõ (bathroom or outhouse).
Liquid bleach: ¼ cup per gallon of water. Advantages. This is the best option for sanitizing
because it kills a broad range of germs and viruses. Bleach can be purchased at almost any
grocery “mercado” in Luperon. It is cheap, is packaged in plastic, and does not have to be rinsed
from dishes after use. It works in both cold and hot water. Environmental impact is negligible,
because chlorine evaporates quickly. Disadvantages. Bleach is corrosive and can splash, colored
clothing may be ruined on contact. It does not cut grease, so it is used after dishes are washed with
dish soap, which may have environmental impact.
Dishwasher tablets: 1/8 teaspoon per gallon of water. Advantages. These hard chunks of
dishwasher cleaner contain bleaching chemicals and kill germs and viruses. There are some cheap
“no name” varieties, which will do. Bring to DR with you. They are easy to transport and are less
likely to ruin clothing so sanitizing water can be used for laundry later. Does double-duty as dish
soap / sanitizer and cuts grease. Disadvantages: Work best when dissolved in hot water (often not
available); they should be cut into small pieces to help dissolution. Environmental impact is greater
because most contain phosphates; however, the amount is miniscule. Rinse dishes with clean
water as final step. Dishwasher powder, if used in place of tablets, can be brought to DR in tight
sealing prescription containers or zip bags. Be sure to label them.
Oxiclean: Follow label directions. Advantages. Uses sodium percarbonate, is nontoxic,
biodegradable, and environmentally safe. Kills germs, viruses, and fungi. Safe for most
colored clothing so can be used for laundry. Dissolves and works well in warm water.
Powder form easily transportable. Bring to DR with you. Disadvantages. Does not cut
grease well, so should be used after dishes are washed with dish soap. Rinsing dishes after
using this is recommended, but is not required.
Updated March 24, 2013
16
MEDICAL PREPARATION FOR DR (by Robert F. Tyree, MD)
IMMUNIZATIONS: It looks like Hepatitis A (2 shots, 6 months apart), Typhoid immunization (1 shot),
and a review of routine immunizations (such as tetanus) will be what most travelers to the
Dominican Republic will need.
Although the full, 2-shot Hepatitis A series takes 6 months to complete, the U. S. Centers for
Disease Control web site says: "One month after receiving the first dose of hepatitis A vaccine,
94%-100% of adults and children will have protective concentrations of antibody." The second
Hepatitis A shot is only to promote long-term protection. Alternatively, there is Hepatitis A immune
globulin, which takes effect immediately after administration and lasts three months.
MEDICATIONS: For malaria prophylaxis, oral Chloroquine 500 mg is recommended weekly, starting
one week prior to departure and continuing until four weeks after returning home.
PHYSICAL EXAM: We suggest that all participants complete a physical examination with their
physician and submit the form to their group leader. The form should provide enough information
for crew leader to understand medical issues and allow the participant’s physician to provide
cautionary comments as appropriate. This form is only the for crew’s use and not for the project.
Any appropriate form may be used, such as the Annual Health and Medical Record from the Boy
Scouts of America (available from their National web site).
SUMMARY: The best way to handle the medical preparation is to print out the CDC web information
and review it with your personal physician as soon as possible, but at least one month prior to
departure.
ADDITIONAL HEALTH ADVICE (from www.cdc.gov):
Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water,
fountain drinks, and ice cubes.
Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember:
boil it, cook it, peel it, or forget it.
Protect yourself from mosquito bites:
Pay special attention to mosquito protection between dusk and dawn. This is when the type of
mosquito whose bite transmits malaria is active.
Wear long-sleeved shirts, long pants, and hats (between dusk and dawn).
Use insect repellents that contain DEET (diethylmethyltoluamide). Skin-so-soft does not contain
DEET.
Purchase a bed net impregnated with the insecticide permethrin or deltamethrin. Or, spray the
bed net with one of these insecticides if you are unable to find a pretreated bed net.
(Note: Our work at The Village Mountain Mission project is generally in the summer, which
is the dry season in the Dominican Republic; mosquitoes are usually not a major problem
then.)
Below are the relevant links to the U. S. Centers for Disease Control traveler's information web site:
http://www.cdc.gov/travel/caribean.htm
http://www.cdc.gov/travel/regionalmalaria/caribean.htm
Note that there is also a free clinic in Luperon that the project has used.
Updated March 24, 2013
17
HURRICANE SAFETY
Since our work is in the Caribbean, some people will be concerned about hurricanes. Generally
hurricane season does not start until late August, well after our last group is gone. The Luperon
area is considered to be the safest harbor in the Caribbean. The project area is protected by high
mountains (10,000 feet in elevation) to the south and east of us. We stay out of low-lying areas and
do not operate in steep valleys.
The following information is provided for those that want to do advance planning “just in case”.
PROFESSIONAL THOUGHTS PROVIDED TO US
{This was prepared by Dick Faurot, a meteorologist at TV station KOTV (CBS affiliate) in Tulsa,
Oklahoma, on hurricane precautions while in the Dominican Republic. Dick is a cousin to our Board
Vice Chair.}
A couple of things to keep in mind while you are there. Assuming you are not right on the beach or
even close to it, then your greatest threats will be from flash flooding and mud slides. I know the
wind is a real concern, but most hurricanes will have winds less than 100 mph and you can hunker
down and get through that. By that I mean stay put in the best built structure available to avoid being
struck by anything that may be flying around and keep in mind the danger of trees being uprooted or
breaking off.
If the spot where you are located is on a valley floor or a steep embankment, then you are
vulnerable to flooding and mud slides. The locals should be able to point out those areas that would
be most susceptible to flooding. {Note: The Village Mountain Mission Project is NOT working in
valleys or on steep embankments.}
The following is from US Government website on hurricane safety.
http://www.aoml.noaa.gov/general/lib/action.html
Stay or Leave?
 When a hurricane threatens your area, you will have to make the decision whether you should
evacuate or whether you can ride out the storm in safety at home.
 If local authorities recommend evacuation, you should leave!
 If you live on high ground, away from coastal beaches, consider staying. {Note: This describes
our sites for Village Mountain Mission Project.}
Copies of The Homeport story are available from Superintendent of Documents, U.S. Government
Printing Office, Washington D.C., 20402. Stock number 0317-0046. Ask G.P.O. for current price.
Updated March 24, 2013
18
Suggested English / Spanish Vocabulary
Yes
No
Hi (hello)
Bye
Please
Thank you
You're welcome
I don't know
Who?
What?
When?
Where?
Why?
How?
How much?
I
You
Much
Little
Friend
How are you?
I am well
What is your name?
My name is ...
I don't understand
Excuse me
Bathroom
Mister
Missus
Miss
Good
Beautiful
Old
Sick
Mountain
Fruit
Water
Boy
Girl
Roof
Small
Large
Man
Week
Si
No
Hola
Adios
Por favor
Gracias
De nada
No se
¿Quien?
¿Que?
¿Cuando?
¿Donde?
¿Por que?
¿Como?
¿Cuanto?
Yo
Tu
Mucho
Poco
Amigo
¿Como estas?
Estoy bien
¿Como se llama?
Me llamo es...
No comprendo
Pardoneme
Baño
Señor
Señora
Señorita
Bueno
Bonita
Viejo
Enfermo
Montaña
Fruta
Agua
Niño
Niña
Techo
Pechito
Grande
Hombre
Semana
Month
Mes
Year
Año
Doctor
Medico
Difficult
Dificil
Easy
Facil
Important
Importante
Other
Otro
River
Rio
View
Vista
Clothes
Ropa
Understand
Comprende
Free
Libre
More
Mas
Less
Menos
Problem
Problemo
Work
Empleo
Village
La villa
Road
Calle
Family
Familia
Food
Alimento
Horse
Caballo
Zero
Cero
One
Uno
Two
Dos
Three
Tres
Four
Cuatro
Five
Cinco
Six
Seis
Seven
Siete
Eight
Ocho
Nine
Nueve
Ten
Diez
Fifteen
Quince
Twenty
Veinte
Twenty-One
Veinte uno
Thirty
Treinta
Forty
Cuarenta
Fifty
Cincuenta
Sixty
Sesenta
Seventy
Setenta
Eighty
Ochenta
Ninety
Noventa
One hundred
Cien
***Bolded terms highly recommended**
Very Basic Spanish Pronunciation Guide
a -- like the a in father
e --like the e in they
i -- like the i in machine
o -- like the o in vote
u -- like the u in rule; silent after q and in the groups
gue and gui
y -- like the i in machine
c -- like the c in cat if before a consonant or a, o, or u;
like an s if before e or i
Updated March 24, 2013
g -- before e or i, like the h in horse; otherwise like the
g in get
h -- silent
j -- like an h in horse
ll -- like the y in you
ñ -- like the n in onion
q -- like a k; always followed by a silent u
19
FINANCIAL RESPONSIBILITY FORM
Village Mountain Mission, c/o Treasurer
Email at VMMtreasurer@gmail.com
This form is to be completed and returned with your group’s deposit. Contact VMM Treasurer for
mailing instructions.
Group Name: _____________________________
Arrival Date __________________
I, _____________________________, the Crew Leader of the above group, agree to be
responsible for insuring that the full cash payment for all participants is made no later than 30days
prior to arrival in the Dominican Republic.
Signed: _________________________________________
Print Name: _____________________________________
Phone Number: __________________________________
Updated March 24, 2013
20
MEDICAL CONSENT FOR PARTICIPATION IN THE VILLAGE MOUNTAIN
MISSION PROGRAMS
(For parents or guardians of Participants under 18 years of age)
Group Name: _______________________
Arrival Date: _______________________
Participant Information:
_____________________________________________________________ _________________________
First name
Middle Initial
Family name
Birth date (month/day/year)
_____________________________________________________________ (____)____________________
Street address
Area code, phone (home)
_______________________________ ____________________ ________
City
State
Zip code
(____)____________________
Area code, phone (cell or other)
In case of emergency, notify:
______________________________________________
Name
____________________________________
Relationship
Home Phone: (____)______________ Work Phone: (____)____________ Cell Phone: (____)_____________
_______________________________ ___________________________
Alternate Contact Name & Relationship
(____)__________________
Alternate Contact Phone
Insurance and Primary Physician:
Insurance company ____________________________________________
Policy No. _________________
Physician ____________________________________________________
Phone No.(___)_____________
Significant Medical Issues:
Please identify all significant medical, health or dietary issues or limitations that the Leaders should be aware of
(include additional pages, if necessary):
Allergies: ________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Medications: ______________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Special Dietary Needs: _____________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Updated March 24, 2013
21
Other: __________________________________________________________________________________
________________________________________________________________________________________
_______________________________________________________________________________________
Medical Release:
I/We the undersigned, parent/guardian of the Participant (a minor), do hereby authorize the ADULT
LEADER(S) IN CHARGE AS AGENT(S) (“Agent”) for the undersigned to consent to any X-ray examination,
anesthesia, medical or surgical diagnostic procedures or treatment, and hospital or other medical care for the
Participant, which is deemed necessary or advisable in the best judgment of the attending physician and
performed by or under supervision of a physician, surgeon or member of the medical staff of the facility
furnishing medical services. It is understood that this authorization is given in advance of any specific
diagnosis, treatment, hospital or other medical care required, but is given to provide authority on the part of
Agent for any treatment deemed advisable. It is understood that in the event of a serious illness or injury,
reasonable efforts to reach me will be attempted.
In case of accident or illness and medical attention is required for the Participant, it should be obtained and
I/we accept full responsibility for all expenses incurred. I/we waive all claims against Agent, the leaders of
these activities, and all officers, agents, trustees, and representatives of the Village Mountain Mission.
Father / Mother or Guardian Signatures ___________________ and __________________ Date __________
For Use by Notary Public
Some countries require all
releases covering minors to
be notarized. Both parents
should sign, even if one is
accompanying the minor
child.
Notary Seal
Subscribed and sworn before me on this
the _____ day of _________(yr) ______
My commission expires:
__________(yr)_____
Signature Notary Public
Updated March 24, 2013
22
Translation for information – English into Spanish / Traducción para la información – Inglés al Español
The parent permission form has been rewritten and is currently being translated into
Spanish. The intent is that both pages be used in giving permission as people looking at
this in the Dominican Republic will likely not speak English.
The revised Spanish version will be included as soon as it is available.
Updated March 24, 2013
23
CONSENT, WAIVER AND RELEASE FOR PARTICIPATION IN THE VILLAGE
MOUNTAIN MISSION PROGRAMS
(If Participant is under 18 years of age – a “minor” – provide information and signatures for a parent or
guardian as requested)
Group Name: _______________________
Arrival Date: _______________________
Participant Name: _______________________________________
THE VILLAGE MOUNTAIN MISSION CODE OF CONDUCT
The Village Mountain Mission programs and activities (the “Programs”) are centered in the Dominican
Republic, which means that we are guests on foreign soil. Your actions are a reflection of The Village
Mountain Mission, your home organization, and the USA. Therefore, The Village Mountain Mission expects
you to act accordingly, meaning that you will be a “model” representative of your country and our mission.
Actions unbecoming of our participants, such that would indicate that you are not acting as expected of a good
representative, may result in your removal from the Programs. Such misconduct may include, but is not limited
to, use of drugs, foul language, argumentative attitude, and operating independently (such as leaving the site
without group leadership approval). Use of alcohol at any of our facilities is unacceptable. Use of alcohol or
intoxication by adults in view of minor participants and the use of alcohol by minors is prohibited.
If it is determined that you are unwilling to participate in the Programs under these guidelines, The Village
Mountain Mission reserves the right to ASK YOU TO LEAVE (RETURN HOME) AT YOUR OR YOUR
FAMILY'S EXPENSE.
CONSENT, WAIVER, AND RELEASE OF CLAIMS
The undersigned Participant, and the undersigned parent or guardian of Participant (if Participant is a minor),
hereby consent and give permission for the Participant to participate in any and all The Village Mountain
Mission Programs. I (we) confirm that the Participant meets all of the health and physical fitness requirements
of the Programs. Participant also understands and agrees to abide by the Code of Conduct.
The undersigned further consents and gives permission to The Village Mountain Mission to take and make use
of photographs and video bearing Participant’s image in print, film, and/or electronic form for educational
and/or promotional purposes.
In consideration of the benefits to be derived from participation in the Programs, the undersigned, on behalf of
themselves, their family, guardians, heirs, successors, and assigns, hereby waive and release any and all
claims against The Village Mountain Mission, or against the officers, agents, trustees, employees, or any other
representatives of any of them, or any persons working under their direction or engaged in the conduct of their
affairs (collectively “Releasees”), arising out of any accident, illness, injury, damage, or other loss or harm to /
or incurred or suffered by Participant or to his or her property, in connection with or incidental to the Programs,
including preliminary training and travel. I (we) understand and am (are) aware of the potential hazards
surrounding the Programs, including those associated with travel to a foreign country and Participant is
voluntarily participating with full knowledge of the risks. Further, I (we) agree to indemnify and hold harmless
the Releasees from loss, liability, damage or cost they may incur in connection with participation in the
Programs and related activities.
Participant Signature_________________________________________ Date _______________
For Minor Participant:
Parent or Guardian Signatures ___________________ and __________________ Date __________
Forward an executed original of this document for each Participant to Bill Benson, The Village Mountain
Mission Project, R. R. 1, P O Box 631, Sugar Grove, OH 43155. Signed forms must be received by 45 days
prior to trip departure. Each group should carry a complete set of these forms on their trip.
Updated March 24, 2013
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Updated January 1, 2013
25
Updated January 1, 2013
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