Testing | Honor Flight Central Coast California

Form #1 – Information Request

Information Request

Form #3 – Get Involved

Get Involved

Reason for Contacting HFCCC*
- I wish to volunteer.
- We are an organization interested in a "Tour of Honor" Presentation.
- I am a teacher interested in the "Tour of Honor" program.
- I am a teacher requesting a Veteran or Honor Flight Central Coast California Board member to visit my school.
- Email me your monthly newsletter.
- I want to volunteer as a medical volunteer on a trip.
- Other
Organization Name
School Name*
Your Name*
City*
Phone*
Email*
Additional Information
Are you human?

Form #5 – Veteran Application

Form #8 – Guardian Application

Guardian Application

Requirements of being a guardian:
- You need to pay for your trip. The current cost is $1500 which covers air and land transportation, food, lodging, attraction entrance fees, flight bag, jacket, and t-shirts.
- If you are a family member of a veteran you must be 16 years or older. If you are not a family member, you need to be 18 years or older.
- Your responsibility on the trip is to assist your veteran with whatever they need which may include pushing your veteran in a wheelchair up to 7 miles during a single day.
- You must be in good physical health, have good eyesight and hearing and be able to walk and lift 40lbs.
- You will be part of a team along with the other guardians who will help veterans get on and off the bus and help load equipment on and off the bus. You will be part of a “bucket brigade” so you will need to be agile, mobile, able to squat, and able to lift 40 lbs.
I have read the above requirements of being a guardian and I can fulfill those requirements. (If you choose "No" you will get an opportunity to explain)*
Please explain what would hamper your ability to fulfill the requirements of a guardian.
Full legal name as it appears on either your Real ID or passport. Provide a copy of the same ID you will show at the ticket counter.*
First Middle Last
Please provide a copy of the same photo ID that you will show at the ticket counter with this application.
Accepted file types: pdf, jpg, jpeg, png, gif, Max. file size: 2 MB.
If you can upload a copy of the photo ID that you will use at the airport, please do so (max file size 2MB). If you can't upload the fill please send a copy to us ASAP via USPS (PO Box 1750, Paso Robles CA 93447). NOTE: Your application will be put in hold until this is received.
Preferred name or nickname
Address*
Street Address City State ZIP Code
Primary phone*
Type*
Secondary phone
Type
Email
Date of Birth*
Month
Day
Year
Gender*
- Male
- Female
Men's T-Shirt size*
Men's Jacket Size*
Are you a veteran?*
Guardians who are veterans will automatically be added to the veterans waiting list of their war time era
Service History
Branch of Service*
Rank (not pay grade)
When did you serve: From (month/year)*
When did you serve: To (month/year)*
In what war era(s) did you serve? (select all that apply)*
- Pre Vietnam
- Vietnam
- Post Vietnam
- Other
If you chose Post Vietnam or Other please specify:
If you chose Post Vietnam or Other please specify:
Military MOS and job description
Additional comments of military history
Emergency Contact Information
Name*
Relationship*
Primary phone*
Type*
Secondary phone
Type
Additional Information
Are you requesting to travel with a specific veteran?*
Veteran Name*
Relationship*
Phone*
Type*
Email
Medical Information
This information will be used in case of an emergency. Information is for Honor Flight and medical personnel only.
Medications*
To add more medications click the "+" at the right of the row. If you have none, enter "none".
Medication Taken Dosage How Often
Please list your physician's name and phone number in case of an emergency.
Physician's Name*
Phone*
Do you have any drug allergies?*
Please list drugs that you are allergic to
Do you have a history of seizures?*
Please describe what type of siezures that you have (e.g. grand mal, petit mal, other)
Date of last seizure
Month
Day
Year

If you have had a seizure within the last 5 years we strongly advise you to discuss this trip with your physician.
Do you have breathing problems?*
Please describe your breathing problems.
Do you have a history of open head injuries, sinus problems, or ear problems?*
Have you flown since the open head injury, sinus or ear problem?
Did you have any problems when you flew before?
It is strongly advised that you discuss the trip with your physician. If you have NOT flown since the open head injury, sinus or ear problem began, we strongly advise you to discuss the trip with your physician.
Do you have urostomy or colostomy bag?*
Please make sure your bag is vented prior to flight. If you do not know if your bag is vented, it is STRONGLY advised that you discuss this with your physician.
Consent
Please Review. You will be asked to sign this later
1. As photographic and video equipment are frequently used to memorialize and document Honor Flight Central Coast California (HFCCC) and the Honor Flight Network (HFN) trips and events, my image may appear in a public forum, such as the media or a website, to acknowledge, promote or advance the work of the HFCCC and the HFN program. I hereby release the photographer and HFCCC and the HFN from all claims and liability relating to said images. I hereby give permission for my images captured during HFCCC and the HFN activities through video, photo or other media, to be used solely for the purposes of HFCCC and the HFN promotional materials and publications, and waive any rights of compensation or ownership thereto.

2. I further state that medical insurance is NOT the responsibility of HFCCC or HFN. I understand that HFCCC and the HFN does NOT provide medical care. I understand that I accept all risks associated with travel and other HFCCC and the HFN activities and will not hold HFCCC and the HFN responsible for any injuries incurred by me while participating in the HFCCC and the HFN program

3. HFCCC provides flight cancellation and liability insurance for those listed on the HFCCC airline sponsored manifest.

4. Refunds are dependent on the amount of funds that are returned to HFCCC from purchases made previously on the guardian’s behalf.

5. The Veteran/Guardian agrees to indemnify and hold the Honor Flight Central Coast California (HFCCC) and its board members harmless from and against any and all claims, liability, loss, expenses, suits, damages, judgments, demands, and costs (including reasonable legal fees and expenses) arising out of (i) the acts or omissions of HFCCC or its board members in connection with Tour of Honor or related events; or (ii) any accident, injury or death to persons, or loss of or damage to property, or fines and penalties which may result, in whole or in part, on a Tour of Honor or related events.

6. I understand that the HFCCC Board reserves the right to deny any application at the Board’s discretion.

Don't worry about signing it online. We will get your signature at a later date.
Signature: ________________________________________ Date: _______________________

Medication Taken	Dosage	How Often

Medication Taken	Dosage	How Often

Form #1 – Information Request

Information Request

Form #3 – Get Involved

Get Involved

Form #5 – Veteran Application

Veteran Application

Service History

Emergency Contact Information

Additional Emergency Contact

Additional Information

Medical Information

Consent

Form #8 – Guardian Application

Guardian Application

Service History

Emergency Contact Information

Additional Information

Medical Information

Consent

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