MOTE Botswana 2018 Mission Exposure Opportunity Registration Form
Please read this letter carefully and all the instruction before completing the online REGISTRATION FORM.

MOTE BOTSWANA 2018 FEES

The fee for participating in this life changing experience is R2750 per person.
The closing date for registration with full payment is 1 June 2018, although a non refundable deposit of R500 should accompany your registration form to ensure your space on the bus.

Bank details will be sent on registration

ACCOMMODATION AND PERSONAL NEEDS

A full list of things you need will be sent on registration, but it is important to note that accommodation will be in tents, which you need to bring with. Due to the lack of space no person will be allowed to stay alone in a tent and we therefore encourage you to indicate on the registration form with whom you will be sharing and who is responsible for taking it. (The sharing of tents is strictly restricted to people of the same gender and out of bounds for the opposite gender throughout the outreach)

Thank you once again for your interest in attending the MOTE experience to Botswana; we look forward in seeing you there!

Name and Surname *
Your answer
Cell number *
Your answer
Who told you about this trip?
Your answer
Email *
Your answer
Age *
Your answer
ID Number
Your answer
Gender *
Passport
Full Name and Surname on Passport
Your answer
Country of Issue
Your answer
Passport number (Type Mote if you do not yet have one) *
Your answer
Passport Expire date
MM
/
DD
/
YYYY
In case of emergency
Emergency Contact Name
Your answer
Relation
Your answer
Cell number
Your answer
Alternative number
Your answer
Medical info
Do you have any allergies, medical conditions, chronic medication or physical limitations?
Your answer
Medical plan
Your answer
Medical Plan Member Number
Your answer
Accommodation
Do you have your own tent?
With whom will you be sharing a tent?
Your answer
If you do not have a tent, do we need to find you someone to share with?
Support
Please give us a list of people and their cell number who will be praying for you. They will be added to a Whatsapp group during the trip
Your answer
Anything else we need to know?
Your answer
Declaration
I hereby certify that all the information in the above document is correct, and I have read and agreed to the Terms stated in the beginning of this form *
Required
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