Expanding and Nurturing the Kingdom of God in Central America and the Caribbean...

Please print this page for each passenger and fill in the following information.  The name must appear as it does on passport. Send completed forms with required deposit to:  Don Shire Ministries    21140 Honeycomb Path   Lakeville, MN  55044

Cruise Date:         Week 1: January 13-20      (cabin type:     inside    outside    balcony)      

                            Week 2: January 20-27  (cabin type:   inside    outside   neighborhood balcony   oceanview balcony)              

Full Name (as appears on passport):_______________________________________________________________________

Street:______________________________________________________________________________________________

City:_________________________________________________State:________________Zip Code:___________________

Phone Number:_______________________________________________________________________________________

Email:_______________________________________________________________________________________________

Date of Birth:_________________________________________________________________________________________

Passport Number:________________________________________________Expiration Date:_________________________

Cabin Mate(s)* (if not included with this registration):_________________________________________________________

Medical Restrictions:____________________________________________________________________________________

Optional Trip Insurance (circle one):     YES       NO       - Contact Cruise Coordinator for details and pricing.

I am applying to be a member of the Mission Cruise Team. I understand that this is a mission trip designed to provide opportunities to represent Christ. With my signature below, I declare that I am a Christian and do my best to live according to the Bible, God’s Word to us. I desire to go on this trip to represent Christ by expanding and nurturing the Kingdom of God.

Signiture:______________________________________________________Date:__________________________________

A Passport is required for this trip.

*Please call prior to registering if you do not have a cabin mate.