Name *

As it appears on your passport

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone Number *

(###)

###

####

Shipping Address (For your En Root Travel shirt) *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you a U.S. citizen? *

Yes

No

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

Is this your first En Root Travel trip? *

Yes

No

Is this your first trip outside of the U.S? *

Yes

No

Is this your first trip to Ghana? *

Yes

No

I understand that it is required by the government of Ghana and En Root Travel, LLC. to abide by the mandatory mask protocol during this trip. *

I agree

I understand that it is required by the government of Ghana and En Root Travel, LLC. to obtain a negative COVID-19 test (PCR) conducted by an accredited laboratory taken no more than 72 hours prior to the date of departure. *

I agree

I understand that it is required by the government of Ghana and En Root Travel, LLC. to obtain a verifiable negative COVID-19 test taken no more than 24 hours prior to departure for re-entry to the United States (En Root Travel, LLC. will provide access to this test). *

I agree

I understand that it is required by the government of Ghana to be fully vaccinated for COVID-19 and to show my vaccination card when needed. (First & second dose) *

I agree

I understand that it is required by the government of Ghana to be vaccinated for Yellow Fever and to show my vaccination card when needed. *

I agree

I understand that it is required by the government of Ghana to apply for and be granted a visa for entry. *

I agree