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Home
Impact
Vision Trips
About
- Our Team
Resources
Events
- COS Banquet
- OR Banquet

GIVE NOW

Home
Impact
Vision Trips
About
- Our Team
Resources
Events
- COS Banquet
- OR Banquet

Home
Impact
Vision Trips
About
- Our Team
Resources
Events
- COS Banquet
- OR Banquet

GIVE NOW

ServeNow Vision Trip Medical Information and Emergency Contacts

Name

First Last

Untitled

Date

Your Doctor's Name:(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Please list any medical conditions that might arise during the trip:(Required)

Please list any medications you are currently taking:(Required)

Please list any allergies you have (food, medications, etc.):(Required)

Emergency Contacts

Emergency Contact 2(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Relationship(Required)

Spouse

Parent

Friend

Relative

Co-Worker

Neighbor

Child

Other

Emergency Contact 1(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Relationship(Required)

Spouse

Parent

Friend

Relative

Co-Worker

Neighbor

Child

Other

Join Us In Serving Like Jesus

GIVE NOW

Our accountability to our donors is one of our highest priorities. Our goal is to use the funds entrusted to us as wise stewards. To do this requires continued monitoring and annual audits of our fund distribution. ServeNow is also a member in good standing with the Evangelical Council for Financial Accountability (ECFA), Candid (GuideStar), and Excellence in Giving (EIG).

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Contact Us

7222 Commerce Center Dr, Suite 220 Colorado Springs, CO 80919-2631
Phone: (719) 900-1800
Fax: (719) 466-6504
ServeNow@weservenow.org

ServeNow is a registered 501(c)(3) non-profit organization.
Tax ID (EIN): 46-1522377