Application Form for Youth Swaziland Trip
12th - 22nd October 2017
Please return application by Friday 17th March to:
David Lyons ([email protected]) or Wendy Brown ([email protected]).
We will notify you of the outcome of the team selection process by Tuesday 21st March.
It is our intention to book flights by Monday 27th March.
The information asked for here will help us to select the mission team and also gives us all the information
we need to be able to book the flights and to contact and liaise with you. Please read the following
information before completing this form.
1. The information sheet about the mission team/trip
2. The risk assessment for the proposed mission team/trip
3. The FCO Travel advice for Swaziland and South Africa (as we are travelling through it).
4. CMS Release and Hold Harmless form.
Name (in full, as printed in your passport):
Date of birth:
Address:
Mobile number:
Home phone:
Work phone:
Email:
Your preferred way of us contacting you from the above:
Nationality:
Passport Number:
Passport Expiry Date:
Biometric passport? If yes it will have this image on the front
(Circle)
Yes
No
Disclosure Scotland (If you have this already. If not leave blank and we will help sort this out later)
 PVG Scheme Membership number
 Issue date
Any special dietary requirements?
Application form page 1 of 2
Any health issues eg dietary, circulatory system, respiratory system, mental health, mobility issues etc. All
information will kept confidential to the CMS team leader and St Mungo’s senior staff. Please also include
any allergies and any long term medication.
Have you been on any previous church mission trips (including with other churches or organisations)? If
so, when and where:
Why would you like to be part of this team? (Use spare space overleaf if needed)
Please complete the declarations below.
I confirm that: (please tick each box to confirm and sign at the bottom)
I have read the risk assessment for this mission trip, the FCO Travel Advice for Swaziland and South
Africa, and the CMS Release and Hold Harmless form, and willingly agree to accept the risks
involved in this trip.
I have a valid Passport that will have at least 6 months remaining by the end of the trip.
I will take all the necessary medical precautions including getting the required vaccinations and
taking suitable anti-malarial medication as prescribed.
I agree to take part in all the training required for the trip.
I agree to follow the St Mungo’s policies and practices for mission trips and to abide by the
leadership decisions and directions of the team leader.
Name:
Signature:
Date:
Application form page 2 of 2
Swaziland Youth Mission Impact Team Oct 2017 – Initial Risk Assessment
Air travel – low risk/v. high impact - use reputable airlines and co-operate with all their safety and security
measures.
General crime – medium risk/medium impact. We will avoid walks in the downtown areas of Mbabane and Manzini
after dark and only travel in remote rural areas in group. A CMS staff member will drive us around Swaziland in the
CMS minibus. Team accommodation is on Hawane Farm which is a large compound with a high wire fence on the
road side. It has other accommodation blocks housing CMS staff and students. The gate is locked at night and there
are night time security guards. There are locks on the team house main doors and bars on the windows, but locks are
fairly unsubstantial. No locks on bedroom doors. Valuables to be kept to a minimum. Bags with valuables can be left
locked in minibus on visits. More detailed instructions will be given to the team before they leave.
Terrorist attacks – very low risk/v. high impact. Follow UK Gov Advice.
Malaria – low risk/high impact – There is a very low risk of malaria in the west of the country where our
accommodation is (see http://travelhealthpro.org.uk/locations/swaziland/#General_information). But anti-malarial
drugs, mosquito repellent, long sleeved shirts for evenings are advisable as we may overnight in the east of the
country where there is a malaria risk. There are no mosquito nets provided. All team members are asked to take
anti-malarials.
GIT infections – medium risk/medium impact. The team will only use bottled water. CMS provide plenty of bottled
water in the team house. Use anti-bacterial hand gel and hand wipes, straws for bottles of fizzy drinks and care when
eating salads/ice-creams (if in doubt avoid). More detailed instructions will be given to the team before they leave.
Conjunctivitis – high risk/low impact - avoid rubbing your eyes with your hands unless just disinfected with antibacterial hand gel.
Rabies – very low risk/v. high impact. Avoid dogs and cats, including puppies and kittens. If anyone is bitten they
will be taken to hospital immediately (This should be no more than 2 hour drive max away). Vaccination is probably
only worthwhile for people going to Africa for much longer periods – but get your doctor’s advice.
AIDS/Hep B infection due to medical treatment – low risk/v.high impact - each member of the team will be issued
with a LifeSystems Sterile needle kit which they will carry with them at all times. The team’s First Aid kit will include
additional sterile needles. Team members are advised to get a Hep B vaccination, as we are likely to visit a rural
health clinic and hospital.
Other diseases – medium risk/high impact - vaccinations as recommended by your GP/Travel Clinic:

Travellers should be up to date with routine vaccination courses and boosters as recommended in
the UK. These vaccinations include for example measles-mumps-rubella (MMR) vaccine and
diphtheria-tetanus-polio vaccine.

Yellow Fever: There is no risk of yellow fever in this country, however there is a certificate
requirement for travellers who have been in countries with risk of yellow fever transmission.

Cholera: Cholera occurs in this country, but most travellers are at low risk. We will only use bottled
water and we will have access to medical care.
Risk Assessment page 1 of 2
Hepatitis A: Hepatitis A is known or presumed to occur in this country, transmitted through contaminated food and
water. Those at higher risk include travellers visiting friends and relatives, and those visiting areas of poor sanitation.
All team members will require a Hep A vaccination.

Tuberculosis (TB): The average annual incidence of TB from 2010 to 2012 was greater than or equal
to 40 cases per 100,000 population. Most travellers are at low risk. Travellers at higher risk include
healthcare workers, those who are visiting friends and relatives (particularly young children), and
those who have close contact with an infected individual. This could be the case for our team, so
take doctor’s advice on need for vaccination.

Typhoid fever - known or presumed to occur in this country. Those at higher risk include travellers
visiting friends and relatives, young children, and those exposed to conditions of poor sanitation. All
team members will require a Typhoid vaccination.

Schistosomiasis - cases were reported in this country in 2012. Travellers should avoid wading,
swimming, or bathing in fresh water. Swimming in chlorinated water is not a risk for schistosomiasis.
There is no vaccine or tablets to prevent schistosomiasis.
Sun stroke/dehydration – high risk/low impact - sunhats to be worn when outside for long periods, good supplies of
bottled water to be carried and drunk at all times.
Travel from Johannesburg airport to accommodation in Hawane, Swaziland – medium risk/high impact – FCO
advise to avoid travelling into or out of Swaziland by road at night as there have been numerous incidences of car
hijacking on major routes from South Africa and Mozambique. We will aim to arrive by lunchtime in Johannesburg to
give us time to complete 4 hour drive to Swaziland in daylight. Pickup by reputable tour company known by CMS
(Taman Tours) or CMS themselves - transport in minibus with seatbelts.
Travel around Swaziland – CMS minibus – low risk/high impact. Minibus has seatbelts. As we will be on the edge of
the rainy season, there is some risk of muddy roads and heavy downpours, also lightning storms. Advice will be
taken from CMS staff and their instructions followed at all times. Livestock (mainly) cattle on the roads is a hazard in
Swaziland and the standard of driving is poor. We will be driven around by an experienced CMS staff member.
Trips/falls/twisted ankles – medium risk/low impact - the trip will involve a lot of walking on dirt tracks. Sturdy
walking shoes are necessary but not full blown walking boots. The team will have a large First Aid Pack with them.
At least one member of the team will be trained in First Aid.
Other accidents – medium risk/medium impact - as there will probably be some manual work involved, there may
be a small risk of injuries involving spades, hammers and other tools. Advice and instructions will be sought from
CMS for every project and visit.
Police Clearance Checks - low risk/high impact - No Visa is needed for a short term trip, but all team members will
need to supply CMS with an up-to-date police clearance certificate. There is a small risk that a team member does
not get this in time for trip. We will advise team members to start this process as soon as they know that they are on
trip.
Risk Assessment page 2 of 2