I, Full Name , declare that all the information and data provided in this form are true. I declare my desire, by signing this application, to enroll in the Vivir Bonito 2024 Cultural Immersion Program, under the modalities and conditions previously established. I declare to abide by the Regulations, as well as to accept the terms and conditions established by the Program's Staff. I declare to understand and accept that any medical expenses that may be generated during my participation in the Program will be borne by me or by the international medical insurance that I wish to contract by my own means. I exempt the Program's Staff from medical and economic responsibility, regarding any eventuality that may occur to me during my participation in it. InCity and country of residence , Date.