Host An Airman Program
Host Application Form
Host Name on Driver's License:
First Name
Middle Name
Last Name
Host Employer/Occupation:
Host Driver's License Number, State of Issue, Date of Birth:
I understand my personal information (name, driver's license number, and date of birth) may be provided to Vance Security Forces Group to accomplish an appropriate background check to facilitate visitor access to Vance Air Force Base.
Co-Host Name on Driver's License (spouse/partner: optional):
First Name
Middle Name
Last Name
Co-Host Driver's License Number, State of Issue, Date of Birth:
I understand my personal information (name, driver's license number, and date of birth) may be provided to Vance Security Forces Group to accomplish an appropriate background check to facilitate visitor access to Vance Air Force Base.
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
example@example.com
Host Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Co-Host Phone Number (optional):
Please enter a valid phone number.
Format: (000) 000-0000.
Are You Married or single?
married
single
Do you have any children?
yes (see below)
no
If yes, please list gender and age of all children in the household.
Ethnicity (check all that apply):
African American
Asian
Caucasian
Hispanic
Native American
Pacific Islander
Other
Prefer not to answer
Religious Preference?
Languages Spoken?
Do you smoke or vape tobacco?
yes
no
Are you willing to host an Airman that smokes or vapes tobacco?
yes
no
Do you use marijuana? If yes, be aware that Airmen cannot use or be around any federally illegal drugs at any time.
yes
no
Any health concerns, physical limitations, or anything else the matching committee should be aware of to best match you?
Do you have any pets? If yes please list kind of animal and number of each kind.
What activities/hobbies do you enjoy:
animals
archery
aviation
baseball/softball
biking
board games/card games
books/reading
camping
cars/motorcycles/mechanics
cooking/baking
crafting/quilting/sewing
dancing
fishing
football
gardening
golf
hiking
hockey
horseback riding
hunting/shooting
martial arts
model building
musical instruments/live music
painting/sculpting
photography
racquetball/pickleball/tennis
running
skatebording
skiing/snowboarding
soccer
tv/movies
video games
volunteering
watching sports
watersports/swimming
Other
Favorite types of food?
Any food allergies? (if yes list below)
Favorite tv/movie interests? (i.e. comedy, drama, reality, documentaries, etc)
Music interests? (i.e. rock, country, jazz, pop, etc)
Any additional comments you'd like to share to help us best match you?
Do you have base access?
yes
no
Airman gender request?
male
female
no preference
Personal Reference 1:
First Name
Last Name
Personal Reference 1 Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Personal Reference 2:
First Name
Last Name
Personal Reference 2 Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
If you'd like to special request an Airman, please list their name and phone number below.
Host Signature
*
1.) I volunteer to participate in the Host an Airman Program (Program), I understand that foreseeable and unforeseeable risks and dangers may arise from the negligence, misconduct, or tortious actions of program participants, which might lead to personal injury, property damage, or death. I understand that my execution of this release of liability waiver is a prerequisite for voluntary participation in the Program. 2.) I do hereby forever waive all claims of liability and release all United States Air Force entities to include, Vance Air Force Base and all affiliated units and commanders from all civil liability, claims, and lawsuits which may arise from my participation in the Program or from negligence, misconduct, malfeasance, or tortious actions of Program participants. 3.) I do hereby forever waive all claims of liability and release the Host an Airman Program and the Enid chapter of AFA from all civil liability , claims, and lawsuits which may arise from my participation in the Program or from negligence, misconduct, malfeasance, or tortious actions of Program participants. 4) I do hereby agree to assume full responsibility for my safety, and indemnify, save, hold harmless, and defend the Government of the United States, its departments, agencies, employees, officers, and agents acting officially or otherwise, from any and all liability, claims, demands, and actions that may occur, resulting from my participation in the Program. This release and liability waiver shall bind all my heirs, successors, and assigns. 5.) Furthermore I hereby agree to assume full responsibility for my safety, and I shall indemnify, save, and hold harmless, and defend Enid AFA's Host an Airman Program, its directors, officers, agents, and employees from any and all liability, claims, demands, and actions that may occur, resulting from my participation in the Program. This waiver of liability release and indemnification shall be binding upon all my heirs, successors, and assigns. 6.) I understand my acceptance into the Program is subject to review by the Enid chapter of AFA's Board of Directors in accordance with the Program's rule and completion of a background check. 7.) I agree to the release of personal information provided by me in the Program's host application only to the Program's Board of Directors and the participating Airman I sponsor. 8.) This release and liability waiver shall not affect my ability to personally sue, file claims against, or file police reports concerning the Airman I sponsor. 9.) I hereby acknowledge that I have read and understand the foregoing, and voluntarily agree to its terms. 10.) Host families are advised that the Host an Airman Program has a "no alcohol policy" for all official events. Use of alcohol in the host family's home is always at your discretion, but host families are reminded that consumption of alcohol by underage military members is a crime in Oklahoma and the military. A conviction under Oklahoma law or the UCMJ will have serious repercussions to the military member's career. It is also a violation of Oklahoma law to provide alcohol to minors.
Co-Host Signature
1.) I volunteer to participate in the Host an Airman Program (Program), I understand that foreseeable and unforeseeable risks and dangers may arise from the negligence, misconduct, or tortious actions of program participants, which might lead to personal injury, property damage, or death. I understand that my execution of this release of liability waiver is a prerequisite for voluntary participation in the Program. 2.) I do hereby forever waive all claims of liability and release all United States Air Force entities to include, Vance Air Force Base and all affiliated units and commanders from all civil liability, claims, and lawsuits which may arise from my participation in the Program or from negligence, misconduct, malfeasance, or tortious actions of Program participants. 3.) I do hereby forever waive all claims of liability and release the Host an Airman Program and the Enid chapter of AFA from all civil liability , claims, and lawsuits which may arise from my participation in the Program or from negligence, misconduct, malfeasance, or tortious actions of Program participants. 4) I do hereby agree to assume full responsibility for my safety, and indemnify, save, hold harmless, and defend the Government of the United States, its departments, agencies, employees, officers, and agents acting officially or otherwise, from any and all liability, claims, demands, and actions that may occur, resulting from my participation in the Program. This release and liability waiver shall bind all my heirs, successors, and assigns. 5.) Furthermore I hereby agree to assume full responsibility for my safety, and I shall indemnify, save, and hold harmless, and defend Enid AFA's Host an Airman Program, its directors, officers, agents, and employees from any and all liability, claims, demands, and actions that may occur, resulting from my participation in the Program. This waiver of liability release and indemnification shall be binding upon all my heirs, successors, and assigns. 6.) I understand my acceptance into the Program is subject to review by the Enid chapter of AFA's Board of Directors in accordance with the Program's rule and completion of a background check. 7.) I agree to the release of personal information provided by me in the Program's host application only to the Program's Board of Directors and the participating Airman I sponsor. 8.) This release and liability waiver shall not affect my ability to personally sue, file claims against, or file police reports concerning the Airman I sponsor. 9.) I hereby acknowledge that I have read and understand the foregoing, and voluntarily agree to its terms. 10.) Host families are advised that the Host an Airman Program has a "no alcohol policy" for all official events. Use of alcohol in the host family's home is always at your discretion, but host families are reminded that consumption of alcohol by underage military members is a crime in Oklahoma and the military. A conviction under Oklahoma law or the UCMJ will have serious repercussions to the military member's career. It is also a violation of Oklahoma law to provide alcohol to minors.
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