Guardian Application « Honor Flight Rochester

Please submit your details below.

Note: Guardians must be at least 18 years old and younger than 70. Spouses of our veterans cannot go on a trip as guardians because of their potential medical issues. Guardians must be at least one generation younger than the veteran they will accompany on a mission.

Contact Information

First Name Middle Initial Last Name Nickname Gender

Male

Female

Address City State Zip Email Address Day Phone Alternative / Cell Phone Date of Birth (Format: Month-Day-Year)
- -

General Information

Occupation Are you a Veteran?

Yes

If a veteran, branch, when and where you served How did you hear of Honor Flight? Please state why you are volunteering Prior Volunteer Experience

Personal Reference Information

Name Address Day Phone Evening Phone Relationship Email

Emergency Contact Information (Someone available when you are traveling)

Name Relationship Address Day Phone Evening Phone Cell Phone

Additional Information

Are you requesting to travel with a particular veteran? *A completed veteran application must be submitted separately

Yes

Veteran Name Relationship T-Shirt Size Can you push your veteran in a wheelchair all day if necessary?

Yes

Medical Information

Medical experience or training (e.g. EMT, CPR, etc.) Please idfentify any physical disabilities, restrictions, and/or medical conditions that could limit your duties as a guardian Dietary Restrictions / Considerations

Terms and Agreement

I Agree to the Terms below

As photographic and video equipment are frequently used to memorialize and document Honor Flight trips and events, images of veterans may appear in a public forum, such as the media or on a website, to acknowledge, promote or advance the work of Honor Flight.

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 promotions and publications, and waive any rights of compensation or ownership thereto.
I further acknowledge that medical insurance is the responsibility of the veteran 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 I may incur while participating in the Honor Flight program.