Guardian Application

Honor Flight Long Island would not be successful without the generous support of our Guardians who play a significant role on every trip, ensuring that every veteran has a safe and memorable experience. Duties include but are not limited to physically assisting the veterans at the airport, during the flight and at the memorials. Guardians pay $400 for the privilege of escorting these heros to DC. ALL GUARDIANS MUST ATTEND THE MANDATORY GUARDIAN ORIENTATION. For more information, call (631) 702-2423. Thank You for your support.

DATE

Date

NAME (Full Name as it appears on your ID for airline travel)

NICK NAME

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

CELL

HOME PHONE

EMAIL (guardian)

example@example.com

DATE OF BIRTH

Date

T Shirt Size: (S, M, L, XL, XXL, XXXL)

Height

Weight

ARE YOU REQUESTING TO TRAVEL WITH A SPECIFIC VETERAN?

YesNo

IF YES, PLEASE NAME THE VETERAN.

OCCUPATION

ARE YOU A VETERAN?

YesNo

If YES, please indicate BRANCH of service, and WHEN and WHERE you served:

How did you learn about the Honor Flight organization?

Why are you volunteering for Honor Flight?

Please list one (1) emergency contact: (someone available at home the day you travel)

Name

Relationship to applicant

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E Mail Address (emergency contact)

example@example.com

Cell Phone

Home Phone

Can you lift 75 pounds?

YesNo

Are you able to push a Veteran (about 175- 225 lbs) in a wheelchair up a slight incline?

YesNo

Are you able to walk 7 miles, while pushing your assigned veteran in a wheelchair throughout a 15-18-hour day?

YesNo

Can you assist your veteran in standing back up if he/she should fall?

YesNo

Please identify any physical disabilities, restrictions and/or medical conditions that would limit your ability to fulfill duties of a guardian. (Because this is a physically demanding day, all guardians are subject to a medical check by our team to ensure they can care for the veteran during his/her flight day)

Do you have a problem with motion sickness? (it is advised if you DO, please see your physician to obtain medication/ or properly self-medicate to avoid issues, as you must be able to function as a guardian the entire day)

YesNo

Please note any medical experience you may have (e.g., EMT, CPR, Paramedics),

PLEASE REVIEW CAREFULLY AND SIGN:

The undersigned acknowledges and agrees that:

As photographic and video equipment are frequently used to memorialize and document Honor Flight trips and events, his/her image may appear in a public forum, such as the media or a website, to acknowledge, promote or advance the work of the Honor Flight program. I hereby release the photographer and Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during Honor Flight activities through video, photo, or other media, to be used solely for the purposes of Honor Flight promotional material and publications, and waive any rights or compensation or ownership thereto.
I further state that medical insurance is the responsibility of the Guardian and I understand that Honor Flight does NOT provide medical care. I understand that I accept all risks associated with travel and other Honor Flight activities and will not hold Honor Flight responsible for any injuries incurred by me or complications from a medical event while participating in the Honor Flight program.

SIGNED*

DATE

Date

* If under 18, a parent/legal guardian must also sign and date below.

SIGNATURE

DATE

Date

GUARDIAN APPLICATION