Host An Airman Program
Airman Application Form
Airman Name:
First Name
Last Name
Gender:
male
female
other
prefer not to answer
Date of Birth:
Airman Cell Number:
Please enter a valid phone number.
Airman Email:
example@example.com
Rank & Unit:
What shift do you work?
Do you work weekends?
Do you have transportation to travel off base?
yes
no
Married or single? If married please enter spouse's name, cell number, and email address.
married
single
Spouse:
First Name
Last Name
Spouse Cell Number:
Please enter a valid phone number.
Spouse Email:
example@example.com
Home City & State:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have any children?
yes
no
Are you allergic to animals?
yes
no
Do you smoke or vape tobacco?
yes
no
Are you willing to have a host who smokes or vapes tobacco?
yes
no
Would you prefer your host be single or partnered?
single
partnered
no preference
Would you like a host with kids?
yes
no
no preference
Any health concerns, physical limitations, or anything else the matching committee should be aware of to best match you?
Ethnicity (check all that apply):
African American
Asian
Caucasian
Hispanic
Native American
Pacific Islander
Other
Prefer not to answer
Religious Preference?
Languages Spoken?
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?
If you'd like to special request a host, please list their name and phone number below.
Airman 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 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. 3.) 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. 4.) I agree to the release of personal information provided by me in the Program's Airman application only to the Program's Board of Directors and the participating host with whom I am matched. 5.) This release and liability waiver shall not affect my ability to personally sue, file claims against, or file police reports concerning the Host. 6.) I hereby acknowledge that I have read and understand the foregoing, and voluntarily agree to its terms.
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