Guardian Application Guardian Application Honor Flight would not be successful without the generous support of our guardians. Please understand that our guardian slots are limited on each flight and very physically demanding. Guardians 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. For further information, please contact Honor Flight Austin at 1-888-530-8880. IF YOU ARE A SPOUSE, YOU WILL BE INELIGIBLE TO APPLY AS A GUARDIAN**** NOTE: Guardians are asked to make a tax deductible donation of $400.00 to Honor Flight Austin to help off‐set the cost of airfare, food, buses, hotel expenses, etc. Thank You for your support. Today's Date * Contact Information (As it appears on your Driver’s License of Government ID) Name * First Name Last * Last Name Middle Name/Initial Nickname Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Email Address * Phone Number * Age * Date of Birth * Gender * Male Female Occupation * Are you a veteran? * Yes No If a veteran, please indicate BRANCH of service, WHEN and WHERE you served. * Personal Reference Name * Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Phone * Email * Emergency Contact Name * Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Phone * Email * Guardian Questions 1. How did you learn about the Honor Flight organization? * 2. Why are you volunteering for Honor Flight? * 3. Please list any prior volunteer experience. * 4. Are you requesting to travel with a specific Veteran, if possible? * Yes No 4a. Name of Veteran / Relationship * Note: A separate application is needed for the Veteran. 5. Are you able to push a Veteran in a wheelchair up a slight incline? * Yes No 6. Are you able to lift, push, pull, carry 150 pounds and push a wheel chair for over 5 miles? * Yes No Note: Being a Guardian is a very demanding and exhausting position. A Guardian must be physically fit to be considered for selection. 7. Please identify any physical disabilities, restrictions and/or medical conditions that would limit your ability to fulfill the duties of a guardian. Also please list any medications taken and how often. 8. T‐ Shirt size * S M L XL XXL XXXL 9. Please note any medical experience you may have (e.g. EMT, CPR, Paramedic) 10. A $400 Tax deductible donation is required to be a Guardian. Which form of payment would you prefer? * Check Online Note: Please only submit the payment if you are CONFIRMED by Honor Flight Austin Please Review Carefully and Sign: The undersigned acknowledges and agrees that: 1) 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 of compensation or ownership thereto. 2) I further state that medical insurance is the responsibility of the guardian and I understand that neither Honor Flight nor the provider of private aircraft ("Flight Provider") provides medical care. I understand that I accept all risks associated with travel and other Honor Flight Network activities and will not hold Honor Flight, the Flight Provider, or any person appearing or quoted in any advertisement or public service announcement for or on behalf of Honor Flight responsible for any injuries incurred by me while participating in the Honor Flight program. Your Signature * Clear Today's Date * NOTE: If under 18, a parent/guardian must also sign and date below. Parent/Guardian Signature * Clear Today's Date * If you are human, leave this field blank. Submit Δ
