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Health & Development in Guatemala Clinical Trip Commitment Form - 2026
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First and last name (will be used for your nametag)
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Preferred pronouns
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Role (will be written on name tag) Ex. Pharmacist, Nurse, Education/Community Development, etc.
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Email
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Phone Number
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I am committed to traveling from June 5-15, 2026 with the EHG team.
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Describe need for flexibility with the established trip dates.
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I have checked that my passport is valid until AT LEAST December 2026. If not a US citizen, I have checked the visa requirements to enter Guatemala and am working on getting one if necessary.
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Passport Number, if not applicable put N/A
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I have filled out my application for the Emory team as a new/returning volunteer according to my status on the Helps website: https://www.helpsintl.org/apply-for-a-team/ (Team #2906 for medical providers, Team #2916 for undergraduates)
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I have paid the $1,650 on the Helps website (links listed above in form description) or on the Momentum website if working through EGPA.
* You can cover the cost in installments. You can also have family and friends make donations on your behalf. You MUST ensure they note your name as the beneficiary and "on behalf of".
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I commit to completing the assigned readings/modules prior to the sessions in the spring (Module 1 due March 15th; Module 2 due April 12th). I understand that not participating in a discussion will affect my standing to travel on the team.
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Select the date for the Pre-departure meeting (just need to attend one)
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Dietary restrictions
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Emergency Contact Name
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Emergency Contact Phone Number
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Accommodations Needed
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Questions?
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