Volunteer Information Form

To help us create a SAFE and enjoyable holiday experience for you, the following form must be completed and SUBMITTED ONCE flights have been booked.

Name *
Name
Date of birth
Date of birth
*Please ensure your passport has at least 6 months validity from departure date.
Emergency contact:
Emergency contact:
Phone *
Phone
ARRIVAL TIME
ARRIVAL TIME
DEPARTURE TIME *
DEPARTURE TIME
ADDITIONAL NIGHTS ACCOMMODATION
Any injuries/ ailments/ disabilities which may prevent you taking part in activities including a cycle tour, yoga, physical building:
NB/ Head, Heart and Hand Holiday volunteers offer contribution in the form of 3 days voluntary building work. Each volunteer is required to raise AUD $250 in contribution to the Wash House Project (unless sponsored.) 75% of the Head, Heart and Hand package price goes directly to support our team and projects in Cambodia. Additional donations in the form of tooth brushes/ tooth paste or funding for on-going toiletry supplies and hygiene education are always gratefully accepted. Nb/ as of 2020 Wash House funding will be included in each package price.
DECLARATION *
In order for you to get the most out of your Head, Heart & Hand Holiday experience and for us to get to know you a little better - please briefly share with us your personal intention (Eg. what you hope to gain from the personal development aspect of the holiday inclusive of your overall holiday experience.)