Thank you for your interest in joining us on our 2026 Vision Trip to the Dominican Republic!

Here are a few additional details…

We are still finalizing the total cost of this trip and will notify you soon. The cost includes a $1,000 tax deductible donation to Anna’s Circle and Multiplication Network, our ministry partner. The money will be used to train more women in the U.S. to share their faith, as well as women called to start new churches globally.
Single rooms are available for an additional $369.
Complete the registration form and mail a $300 deposit to reserve your space.

All payments should be sent to:
Anna’s Circle, Inc.
5307 Tulip Drop Drive
Wimauma, FL 33598

A detailed itinerary will be available soon.

REGISTRATION FORM

2026 Vision Trip to the Dominican Republic

Vision-Mission Trip Participant Information

Please fill out the following information as accurately as possible for our records and in the event of an emergency.

First Name (as on your passport)

Middle Name (as on your passport)

Last Name (as on your passport)

Preferred Name

Date of Birth

City and State of Birth

Phone Number

Address

Home Address

City

State

Zip Code

Do you have any dietary restrictions?

Yes

If yes, what are your restrictions?

Do you have any medical conditions or allergies we need to be aware of?

Yes

If yes, what are your current medications?

Preferred Airport of Origin

Select Type of Room

I'm fine sharing a room with another woman.

I will pay the additional $369 for a single room.

Emergency Contact Information

Emergency Contact Name

Relationship

Spouse

Child

Parent

Other

Emergency Phone Number

Emergency Contact Email

Emergency Contact Address

Traveler Information

Passport Number

Nationality

Passport Issuing Agency

Passport Issue Date

Passport Expiration Date

Waivers

Please read all of the information below. Writing your name at the end of the form will act as a digital signature.

MISSION TRIP RELEASE FORM

Thank you for your desire to join Anna's Circle on a tour of Multiplication Network's work in the nation of Dominican Republic. As you may know, traveling to a foreign country is an exciting experience! We also know it presents the possibility of unexpected events. Please take a moment to read the information below. A signed waiver is required for each person traveling with our tour group. We look forward to experiencing Dominican Republic with you.

I have read and agree to the waiver.

I, the undersigned, seek to join representatives of Anna's Circle and Multiplication Network, a nonprofit corporation, in travel to, from, and about the country of Dominican Republic. By signing this release, I understand and acknowledge the risks inherent in such travel and related activities, including without limitation the risk of personal injury and perhaps even death, and also potential loss of or damage to personal property. I nonetheless knowingly and willingly assume all of these risks. Further, for myself and on behalf of my family, heirs, and personal representatives, and for valuable consideration, I hereby forever release and discharge Multiplication Network, its affiliates and subsidiaries, and its officers, directors, employees, representatives, agents, successors, and assigns from and against any and all costs, expenses, causes of action or liability, including without limitation for personal injury, death or other damage or loss, which may arise out of or in any way relate to my travel to, from or about the country of Dominican Republic, or which may occur during our stay in the country or in other countries en route to or from the country. I hereby further agree to indemnify and hold Multiplication Network harmless from and against any such costs, expenses, causes of action or liability, to include any quarantines related to COVID-19 or any subsequent variant required by any governmental entity. I intend this release to be construed broadly so as to provide the maximum liability protection for Multiplication Network.

I am signing this release voluntarily.

Photograph, Video, and Written Story Release

I have read and agree to the waiver.

I, the undersigned, hereby grant Anna's Circle and Multiplication Network permission to the rights of my image, likeness, and sound of my voice as recorded on audio or video tape and any written stories that are about me that may or may not include my full name, without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. Photographic, audio, or video recordings and any written stories may be used for the following purposes: conference presentations, educational presentations or courses, informational presentations, online educational courses, educational videos. By signing this release, I understand this permission signifies that photographic or video recordings and any written stories of me may be electronically displayed via the internet or in the public educational setting.There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio or video recordings and any written stories collected as part of the sessions listed on this document only. By signing this form, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

By typing my full name below, I acknowledge I have read the waivers and this is my digital signature.