Online Form to Visit Vida Joven de México
Name *
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Email *
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Date of upcoming visit *
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Want to be on the Vida Joven e-news list? (includes fun pics of the kids!) *
Please fill out all of the information below.
Will you ride on our van for the trip? ("No" means you are providing your own transportation to/from the orphanage) *
Street Address *
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City *
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State *
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Zip Code *
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Phone *
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Emergency contact #1: Name and phone *
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Emergency contact #2: Name and phone
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Do you have any medical issues we should be aware of in case of an emergency? *
Your answer
Please type in your full name below to signal your consent to the following:
I consent to travel with Vida Joven de México to visit its children’s home in Tijuana, Baja California, Mexico (“Program”). I acknowledge and understand that certain dangers or hazards may arise in international travel that may present elevated risks to my health and safety or may cause unforeseen delays, including but not limited to: weather, road or traffic conditions, civil unrest, criminal activity, police activity, exposure to reduced sanitation, disease, war or acts of God.

In connection with or arising out of my participation in the Program, I assume all risks of injury, loss or damage, known and unknown, foreseen and unforeseen. I grant permission to Vida Joven de México and any of its employees, volunteers, agents or representatives acting in any capacity (collectively, “Vida Joven”), in the event of a medical emergency, to make all reasonable efforts to provide me needed first aid reasonably within their abilities; or to obtain medical care for me.

On behalf of myself and my heirs, assigns, successors, personal representatives or trustees, I hereby release and forever discharge Vida Joven to the greatest extent permissible under California law, of all liability, claims, demands, actions or causes of action for any loss, damage or injury to my person (including death) or property; agree to indemnify, hold harmless and defend Vida Joven from any and all liability, loss, damage or expense, including attorney fees and costs.

I am advised to maintain appropriate health insurance; to review relevant United States consular or State Department information pertaining to Mexico; and that conditions in any foreign country may change rapidly. Should I wish to secure international travel insurance I will seek it out.

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