Registration: UK/Illinois -- DR-- Registration and Payment Deadline 11/4/19 (01-04-2020 - 01-11-2020 )

USER INFORMATION

To ensure proper registration, please watch this video first:


Title:
First Name:
1
Last Name:
1
Organization/School:
Classification (year in school, graduate, other):
Participant interest?:
Medical  Dental  
Address:
City:
State/Province:
Zip / Postal Code:
Country:
Email:
Confirm Email:
Phone:
Spanish language level?:
Gender:
Birthdate:
Passport Number:
Passport Issuing Country:
My passport is valid for at least 6 months AFTER departure date or I will have a new passport before departure:
Yes
Please enter contact information for 2 people we can contact in case of an emergency :
1
Please enter any special dietary needs (vegetarian, etc.):
For emergency and planning purposes, please list any significant medical history, medications you are taking or known allergies:

STUDENT PARTICIPATION AGREEMENT

All persons/students participating in any travel program of Global Medical Training, hereafter referred to as "GMT," must accept the following statements:

1. I do voluntarily and without reservation on behalf of myself, my heirs and my estate, release and discharge absolutely and forever, GMT, and any of its agents or program partners, and waive all claims, demands, of whatever nature for any injury, loss, damage, accident, delay, actions or cause of action, known or unknown, which I now have or may acquire in the future, irregularity or expense arising out of or directly or indirectly relating to my participation in a GMT program, and arising from the use of any vehicle or services, strikes, war, acts or terrorism, weather, unforeseen acts of nature, sickness, quarantine, government, airline, buses, transporting company, firm, individual, or agency. I understand the terms of this Release and the consequences of it and acknowledge that I have not executed it under duress.

THIS IS A RELEASE.

2. I grant GMT or one of its agents, full authority to take whatever action they feel is warranted regarding my health and safety and that they may arrange medical treatment for me, at my expense and that if deemed necessary by the GMT personnel and/or local medical authorities or if you should so request, I will be sent back home at my own expense for further medical treatment.

3. I will comply with all the required visas and international travel documents requested by authorities in destination and transit countries in which I travel, as well as their required expiration dates for both passports and Visas. All passports must not expire any sooner than six months after the trip date. I understand that failure to comply will result in trip cancellation at my own expense.

4. Plane tickets are not included in the registration fee; it is the responsibility of the participant to purchase them. Do not buy your flight tickets until your trip is officially confirmed by the  GMT Central Office. This will occur when a minimum of fifteen (15) students have registered and paid. If this number is not reached by the deadline date the trip will be canceled and your paid trip fee will either be forwarded to a future trip of your choice or that listed trip fee will be fully refunded to you.

5. If I cancel my trip for any reason or fail to comply with any international travel regulations, THERE WILL BE NO REFUNDS. However, you can make a written email request that 80% of your paid amount be applied, as partial payment, to any future GMT trip of your choice. You must pay the balance between this forwarded amount and the future trip actual posted fee on the GMT website when you register for that trip. The other 20% will be used by GMT to pay for reservations and services that were covered in advance for you on this canceled trip. It is rare, but If GMT cancels your trip, you will be issued a full refund of your paid GMT fee. So far, this has occurred only because fewer than 15 students have registered and paid.

6. I understand this is a supervised program and agree to uphold individual and group standards set forth by GMT personnel. These standards include -No alcohol abuse or use of any illicit drugs. -No females in male sleeping area and vice versa; -A midnight hotel curfew applies for the entire trip; -No trip extensions or on-site visits by friends/family not previously planned/authorized by GMT; -Students with special diet requirements must bring their necessary dietary supplements; -If I have any reason to leave the trip group, I must first obtain the permission of a responsible GMT staff member; I will never leave the hotel by myself but rather always with a group; within the hotel I will always be with at least one other trip member [‘’buddy up’’]; there will be absolutely no sexual contact allowed between students or between students and staff…GMT has zero tolerance for this and GMT staff know that any violation of this is cause for immediate permanent termination of employment; These standards are for safety and security reasons.

7. If my conduct is deemed incompatible with the interests, safety, and standards of the group and if my participation on the trip is TERMINATED, no refunds can be expected and returning to my home is at my own expense. A verbal warning will be provided before expulsion from the program. A written report will be provided later.

8. I understand this is NOT primarily a tourist-type program. It is an international humanitarian team effort serving disadvantaged people in sometimes remote and difficult circumstances which, on occasion, may include travel over long distances, on land, air, and water, on safe transportation.

9. I grant GMT permission to reproduce photographs or movies, of me, taken during the time that I am participating in this program, including written statements I may make concerning this program.

10. The calendar deadline for all GMT trip applications and all GMT trip payments is eight (8) weeks before the beginning trip date for which you have applied. Our staff needs this to finalize reservations and services for you. When you apply [register] for a trip, you will be placed on the ''applied for'' list for that trip. When you submit your payment, you will be placed on the ''final trip list''.

11. I declare that I am not addicted or habituated to the use of non-/or prescription mood-altering drugs/chemicals, including alcohol, and will not seek these drugs while on a GMT trip.

12. A midnight curfew applies for the entire trip for safety reasons. This means that all trip participants and GMT staff must be inside our hotel before midnight and remain there the rest of the night.

13. No alcohol abuse or any illicit drug use will be allowed. If this is violated, the participant(s) will be specifically warned, verbally and in writing, and a second violation can result in a dismissal of that participant from the remainder of the trip. There will be no refunds, and any additional related expenses will be paid by that trip participant.

14. Travel and health insurance is the responsibility of each trip participant.

15. All GMT website posted trips begin at 12:00 AM on day one and end at 12:30 PM on the last posted day of the trip. Hotel check-in time is at 1:00 PM. Any trip participant activities either before or after those times are not the responsibility of GMT. This includes any tours, visits or sightseeing that I may elect to do in the trip country or elsewhere or arriving before check-in time. I do those things upon my initiative and responsibility and at my own risk, whether before or after the GMT trip.

16. If your flight arrives between the above-stated trip times and if you have sent your flight itinerary to the country Program Director in advance of your flight, GMT staff will meet you at the airport. Likewise, GMT staff will escort you to the airport for your departure flight. GMT doesn't own transportation services in any of the countries where we develop our programs. We work with reliable and trusted third party providers, all of whom comply with strict insurance policies per their countries regulations. Please note that airport-hotel-airport transportation fees are not included in the registration fee and will depend on group sizes at the time of arrival, and the countries transportation rates.

Please show this agreement to your parents or any other person(s) who may feel a shared responsibility for your well-being.

I have read and accept this agreement:
Yes

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