Individual Application

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Please enter information in the form below to process application for event The Big Island of Hawaii: An Insiders Visit, with Honolulu Extension – November 8-16/18.

IMPORTANT:
1) Please make sure you're logged in before applying!
2) The last item to complete on this application is a check box. Please make sure to check it before you click on "Process Application" or your application will not be recorded in the system. Thank you!
3) When your application has been processed, you will receive an email confirmation copy. If you do not, please log back in to complete all necessary fields and resubmit.
4) Each trip applicant requires a separate application. However, for your convenience, you may apply for multiple individuals using your Local Hope account.

Thank you for applying! You will receive a confirmation of your application. Watch for updates on this adventure soon.

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1) If this is my first time on a volunteer-service trip organized by Local Hope, I will complete the required Orientation.*** *

I Agree.

1) If this is my first time on a volunteer-service trip organized by Art Ambassador and Local Hope, I will complete the required Orientation.*** *

I Agree.

2) I will be on time to all activities. *

I Agree.

3) I will bring my best to the trip, including my enthusiasm, patience, a listening ear and an open heart. *

I Agree.

4) I will recognize as my equal and show respect for each member of my Team, the Staff, and all those we serve alongside during my service trip experience. *

I Agree.

5) Should I take ill; become injured, overly anxious, frustrated or experience any other issue that is interfering with my experience, I will seek the help of a Trip Leader to quickly resolve the issue. *

I Agree.

6) I will follow safety guidelines that will be presented during my Orientation. *

I Agree.

7) I understand that the Orientation for this trip is mandatory for both adults and minors. I agree to attend the Orientation and ensure that any minor children traveling with me also attend on the date listed for Orientation for this trip, or during the single makeup that will be offered based on the day that the majority of participants can attend. If I can’t attend either of these for either reason, I understand that there will be an additional $200 fee for a second makeup session and I agree to pay it so that I may participate in this trip.

You must Agree *

I Agree.

Health and Re-Entry Policy

1. RE-ENTRY - I will abide by any vaccination policy pertinent to re-enter my home country, and understand that I am solely responsible for completing paperwork or presenting proof required, if any, to re-enter.

2. GROUP HEALTH - If I have cold or flu symptoms during my experiences, including a runny nose, fever, headache, cough, or other symptoms, I agree to mask, wash hands frequently, and take related precautions to assist in ensuring group health.

Health and Re-Entry Agreement *

I agree to "Health and Re-Entry Policy"

*** Orientation - A formal orientation will be held some months prior to each trip and is conducted by Zoom.

Part 2 - Applicant’s Information

First Name *

Middle Name

Last Name *

Address *

Address 2

City *

State *

Zip *

Country *

Email *

Best Phone *

Date of Birth *

Honolulu Extension *

I wish to add the Honolulu Extension to my trip (+$1051)

I don't want to go to Honolulu

Private Room/Single Occupancy (Big Island +$189 x 8 nights) *

Yes I want a private room!

I am currently alone, but would like help finding a room mate! (Note: We can't guarantee we'll find someone for you, but we will share your name with the group. If you are successful in acquiring a roommate, the single-supplement charge will be credited back to you.)

No, I have a roommate (or roomates). (If so please enter name(s) below)

Private Room/Single Occupancy (Big Island +$189 x 8 nights, Honolulu +$189 x 2 nights) *

Yes I want a private room!

I am currently alone, but would like help finding a room mate! (Note: We can't guarantee we'll find someone for you, but we will share your name with the group. If you are successful in acquiring a roommate, the single-supplement charge will be credited back to you.)

No, I have a roommate (or roomates). (If so please enter name(s) below)

Roommate Name(s)

If sharing a room, please confirm desired accommodation:

One Bed

Two Beds

Three Beds (Note: May not be available at all locations)

Extras

EARLY ARRIVAL - I would plan to arrive on November 7, and would ask that you include this night for me at the Royal Kona. Note: If a double or triple, only select on one application. (+318) *

LATE STAY - I have chosen the Honolulu extension and wish to stay and extra night, the night of November 18. Thank you for making that reservation for me. Note: If a double or triple, only select on one application. (+$449) *

November 18 – After our time together in Honolulu, I plan to stay and ask that you include this night for me at our chosen hotel (+$449) *

Emergency Contact/Health Information Form

Emergency Contacts Name, Relationship and Telephone *

Medical conditions: Medical treatment may not be available near work sites, so it is important to list special medical conditions that apply. Certain vaccinations are required for ALL participants including measles/mumps/rubella, polio, tetanus. Ask your physician about hepatitis A and hepatitis B.

Do you have other physical/medical conditions of which project leaders should be aware? (i.e., bad back, trick knee, etc.) *

List Any Special Medications You Need: *

Special Diet? Vegetarians, please note: Vegetarian fare may limited or unavailable in some locations. If you need certain foods, you may need to bring a private supply.

Special Diet *

Allergies (type and reaction) *

Wearable Branded Items (“Swag”)

One branded shirt item comes with your trip. If you prefer, you may select a different item including a Vest, Stonewash Cap or Tote (additional cost may apply).

Shirt Size *

Shirt Style *

I already have a Branded Project t-shirt

I would prefer to skip the t-shirt so please give me a credit ($20) toward one of the other items.

Additional Branded Items

Name-Brand Quick-Dry LS Shirt, Khaki (+$68)

Stonewash Cap (+$20)

Part 3 - Trip Costs, What’s Included and Policies

What's Included

See Details in trip description

What's Not Included

1) Airfare. You’ll need to purchase your tickets and arrive with the group or prior if you are not traveling on the group schedule. 2) Meals not mentioned in the description. 3) Trip Cancellation Insurance that will cover all costs, including Local Hope costs (recommended). 4) Single Room Supplement if for any reason you room alone. 5) Other Costs resulting from late arrival, personal other. 6) Personal other.

Refund Policy

Your $1000 deposit is integral to our planning since it is used to book hotels and transportation, purchase supplies, and to pay our caring staff who expend considerable time and effort planning a wonderful experience for you. Your deposit is therefore non-refundable if for any reason your plans should change.

For these reasons, we strongly advise that you purchase trip cancellation insurance. The balance of fees are refundable as follows (see “Exceptions”): 100% within 91 days of travel. Full payment is due 90 days before travel, and is non-refundable after that point.

Exceptions: In the case of a natural disaster or travel ban imposed by the U.S. or destination, and/or flight cancellations due to such restrictions, our trip together will be rescheduled and we will offer you full credit toward this or a future Service or Explore trip with Local Hope within two years. Thank you for your support and understanding. Please note that as a traveler for our non-profit organization, 100% of your contribution and expenses may be tax deductible (please consult your tax professional). A tax receipt for the full amount contributed through Local Hope is provided by January 31 of the year following your participation. We suggest you keep a copy of meal receipts and airfare which may also be fully tax deductible.

I understand what’s included, what’s not included, and the refund policy. *

I completely understand and agree to all information outlined in Parts 1-3

Release of Liability/Service Trip Participation

This Agreement is made today, the date of this application, by and between the Applicant and Local Hope / Xela AID Partnerships for Self Reliance (“Local Hope”) and any group ("Third Party") for which Local Hope has organized a Volunteer Service Trip.

(1) PARTICIPATION - I acknowledge that my participation is strictly voluntary, and further recognize the inherent risks associated with international travel. Accordingly, I agree to assume any and all risks relating to my participation in this Service Trip. I understand and acknowledge that my participation is in the capacity of a Volunteer and that nothing contained herein or in any additional document executed in connection herewith shall be construed to create an employer-employee partnership or joint venture relationship with Local Hope or Third Party, either now or at any time in the future. Additionally, I am advised that while traveling with Local Hope and Third Party where applicable, I am acting as an ambassador, and that inappropriate actions on my part even if well intended could inure harm to Local Hope, Third Party and other partner organizations. I thereby agree to follow the guidelines distributed during Orientation, and not to violate any law in the U.S. or abroad in connection with this Trip.

(2) APPROPRIATE BEHAVIOR - I will not during said Trip: (a) Become involved in any political movement; (b) Proselytize; (c) Give nor promise funding to any individual or organization within Local Hope's service area with whom I have no connection prior and distinct from this Service Trip; (d) undertake these activities involving any member of Local Hope’s staff or a program participant should I return in the future; or (e) Harass or demean or make unwanted sexual advances on any fellow team member or anyone I come in contact with for the duration of the Volunteer experience.

(3) APPROPRIATE BOUNDARIES - Should I be asked for money or passage to the United States, I will report this immediately to a Trip Leader. Should I wish to help an individual or group I have met while on this Service Trip, I will work through the well-established and carefully managed program structure of the Local Hope organization.

(4) ORIENTATION - I agree to attend the mandatory Orientation and understand that it is a requirement of participation in this Service Trip.

(5) HOLD HARMLESS - I agree to hold harmless and indemnify Local Hope and, if any, Third Party directors, agents, employees and staff from and against any and all costs, liability, demands, claims, damage and expenses of any nature or any kind incurred in connection with my participation as a Volunteer. I understand that this Release of Liability and Service Trip Participation Agreement is in consideration for allowing me to travel and volunteer in Guatemala in connection with said Service Trip and but for said Release, I would not be allowed to participate.

Release of Liability/Service Trip Participation Consent *

I have read the foregoing Release and acknowledge the contents thereof. Accordingly I hereby consent to the above individual’s participation in this Service Trip and the Release of Liability.

Comments

Name on Payment Method *

Name of Applicant is the SAME as on Credit Card being used

Name of Applicant is DIFFERENT than on the Credit Card being used

Exact Name on Credit Card being used for payment *

Payment Information

Coupon

Amount

Discount Amount

Gross amount

Deposit Amount

Payment Type

Payment Method

Paypal / Credit Card

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*