2024 MARCH OF THE LIVING - ADULT PROGRAM APPLICATION

GENERAL INFORMATION

An application needs to be completed for each adult.  The application will take approximately 15 - 20 minutes to complete and should be done in one sitting, but you can save it if necessary.  Dates, however, will not save. 

You will need to upload both sides of your health insurance card and a copy of the inside page of your passport.  Your passport must expire after December 15, 2024.  If you do not have a passport you will need to apply for one now; if your passport will expire prior to December 15 2024, you will need to renew now.  It can take several weeks in either case.  If applicable, you can upload a copy of the application/renewal form in place of the inside page of your passport in order to continue the application.

You will also need information on any hospitalizations or illnesses as well as the medications/dosages you are currently taking.

A refundable application fee of $180 is required at the time of the application. A link will be sent to you upon receipt of the application. Payment and cancellation policies will be sent.

Trip insurance including medical will need to be purchased, however, we ask you to wait until we send you more information, including minimum amounts required.

2 legal passport pictures will be required and can be mailed to March of the Living or dropped off at our office, 5890 S Pine Island Road, Davie, Fl  33328

Please note: There is a minimum number of participants necessary prior to December 8, 2023 in order for the program to take place.

If you have any questions, please contact me at galboukrek@jewishbroward.org or 954 660 2077.  

Galit Alboukrek, Director Teen Engagement Experiences and March of the Living

Jewish Federation of Broward County

It is our intention to rely on the medical information you submitted above and any supplemental letters from specialists or mental health professionals in determining your acceptance and continuation in this program.  Omissions or misstatements are at your risk and that of your physician(s) or therapist(s).

Should you be found to have any condition, mental or physical, that is not fully disclosed on this form, or in an accompanying letter from an appropriate, qualified medical or mental health professional, you may, at the sole and absolute discretion of the program, be asked to return to the US at your own expense, or be treated in the country(ies) you are visiting at your own expense and there shall be no refund of monies paid.  The leadership of this program, International and local and its sponsoring organizations, including the International March of the Living and the Jewish Federation of Broward County, their employees, volunteers, or designates are hereby released from all responsibility or liability of any kind whatsoever arising out of any aspect of your medical history and mental or physical condition.  

If any changes take place in your medical condition prior to departure, you must immediately submit an explanatory letter, signed by an appropriate, qualified medical or psychological professional, detailing your diagnosis, prognosis and treatment.  Failure to submit such a report may result in your being asked to leave the program at your own expense with no refund of fees.

I certify that I am able to participate on the March of the Living, knowling I will undergo different sleep patterns, frequent and lengthy bus travel, early wake ups and numerous hours of walking and being on my feet.

 

PHOTO/WRITTEN WORD RELEASE

I consent, for all purposes, to being interviewed, photographed, videotaped and/or filmed by the Broward County March of the Living, the Jewish Federation of Broward County and/or the International March of the Living and its affiliates, for use in all media and in all manner of promotion, including, but not limited to, marketing spoken and written words, art work, music and/or photographs or video presentations pertaining to the March of the Living.

I release the reporter/photographer/camera person/editor/staff and his/her nominees and designess, from liability for any violation of any personal proprietary right I may have in connection with such sale, reproduction or use.

LIABILITY WAIVER #1

In addition to the Medical Assessment agreed to above, the indersigned agree to hold the March of the Living, Inc ("March"), and the Jewish Federation of Broward County ("Federation") as well as any other organizations, harmless from any claim, loss, damage, bodily injury, personal injuries, including emotional trauma, known or unknown, death, liability or expense (including attorney's fees) which the undersigned participant might sustain/alleged sustain or incur/alleged incur in connection with, as a result of, or by reason of their participating in the March of the Living or any of the activities relating thereto, whether based upon the negligence or breach of contract by any of the above mentioned organizations/agencies of their representatives.

The organizations sponsoring the March of the Living operates the tour offered under this program only as agents of the airline, bus operation, hotel facilities and others which provide the actual arrangement and are not liable for any act of omission, delay, injury, loss, damage or nonperformance occurring in connection with these arrangements.

By agreeing below and signing below, in addition to the above waiver,the participant agrees to abide by all rules and regulations as set forth by the International March of the Living, March of the Living Broward County and/or the Jewish Federation of Broward County