MARCH OF THE LIVING - SOUTHERN REGION April 19-May 3, 2020
Applicant Statement for Adult Participants
By enrolling in the March of the Living Program, I hereby agree to the following:
Acknowledgements• I will participate fully in all its aspects.• I agree to hold the leadership of the March of the Living, the cooperating agencies of the Southern Region, its representatives and staff, harmless of and from any and every claim arising from or by reason of any bodily injury, personal injuries known or unknown (including emotional trauma), death, or property damage resulting or alleged to result from any accident, incident, or other episode that may occur, whether based upon the negligence or breach of contract by, any Releasee or any other persons for whose acts or omissions any Releasee may be responsible in law or in fact, or any other use or principle of law as a result of my participation in the March of the Living or any activities in connection with the March of the Living or any other activity pertaining to this program, and agree to indemnify the sponsors of the March of the Living and its employees and cooperating agencies and staff for any costs which may arise in connection with this trip.
Medical• I hereby certify that the Medical Information section is complete and full disclosure on any and all physical and Mental health issues have been included. It is the intention of the March of the Living to rely on this completed form and supplementary letters in determining my acceptance and continuation in the program. Omissions or misstatements are at my risk and that of my physician(s) or therapist(s). ~ Should I be found to have any mental or physical condition that is not fully disclosed in this Medical Form or in an accompanying letter from an appropriate, qualified medical or psychological professional, then …. a. …. I may, at the sole and absolute discretion of the program, be dismissed from the program prior to departure or returned to the USA at my expense, or be treated in the countries I am visiting, at my expense, and there shall be no refund of monies paid to the program. b. …. the leadership of this program and its sponsoring organizations are hereby released from all responsibility or liability of any kind whatsoever arising out of any aspect of my medical history and mental or physical condition.• All medication that I take regularly is detailed in this Application Form in the Medical Information Section. ~ I will travel with a written generic prescription for each medication I take. ~ I must also bring two complete sets of my medications with me.
I give my full permission for all treatment of any nature deemed necessary by doctors in Europe, Israel, and the USA to be extended to me within the framework of the medical services of the March of the Living leadership.
I agree to a payment plan as outlined, herein:
DUE immediately after submitting this online Application:
~ $1,500 deposit, of which 100% is FULLY refundable through August 31, 2019, with request, dated and in writing
~ DUE BY November 1, 2019: Remainder of balance due. I am aware that a late payment fee of 5% of my balance will be assessed if I do not pay my bill, in full, by November 1, 2019.
All withdrawal requests must be written and dated to take effect.
March of the Living Southern Region Cancellation & Refund Policy
Through August 31, 2019: FULL REFUND
From September 1, 2019 through November 1, 2019: Refund less $1,000.
From November 2, 2019 through December 1, 2019: Refund less $2,500.
From December 2, 2019 through January 31, 2020: Refund less $3,800.
From February 1, 2020 through March 10, 2020: Refund less $4,500.
March 11, 2020 and after: NO Refund
~ Participants canceling prior to the dates indicated would receive all monies paid as a refund less the indicated un-reimbursed amount.
~ REFUNDS ARE NOT AVAILABLE FOR ANYONE WHO IS LATE IN PAYING.
• I will secure independent trip interruption and withdrawal insurance, with a cancellation, medical coverage and evacuation policy, immediately upon applying for the March of the Living. Proof of purchase will be provided to the March of the Living Southern Region Office immediately. Failure to do this will abrogate this agreement.
• I will submit the photo page of an up-to-date passport and 2 passport size photos to the Southern Region office, immediately.
• I will submit a copy (Front and Back) of my personal health insurance card upon submission of this application.
I have read and will abide by the Cancellation Policy and Refund Policy detailed above. I understand my financial obligations to the Southern Region of the March of the Living.
I have made copies of this declaration and application for my records.