| * indicates a required field |
| Eastern Iowa Honor Flight would not be successful without the generous support of our guardians. Guardians play a significant role on every trip, ensuring that every veteran has a safe and memorable experience. Duties include physically assisting the veteran at the airport, during the flight and at the memorials. Guardians are also responsible for their own expenses (airline fare, etc.) For further information, contact us at EIHF.GUARDIAN@GMAIL.COM. Thank You for your support. |
| ALL INFORMATION IS REQUIRED |
First Name*:
As it appears on your ID for airline travel |
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Middle Name:
As it appears on your ID for airline travel |
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Last Name*:
As it appears on your ID for airline travel |
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Birth Day*:
As it appears on your ID for airline travel |
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| Gender*: |
MF |
| Nick Name: |
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| Veteran First Name* |
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| Veteran Last Name* |
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| Relationship to Veteran* |
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| Are you requesting to be the guardian for another veteran, if so what is their name? |
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| Preferred Phone*: |
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| Alternate Phone: |
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| Email*: |
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| Address*: |
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| City*: |
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| State*: |
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| Zip*: |
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| County*: |
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| Are you a Veteran*: |
YesNo |
| If a veteran, please indicate branch, where and when you served: |
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Polo Shirt (mens) Size*:
A shirt will be provided for you to wear on the flight |
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| GUARDIAN RESPONSIBILITIES REQUIRE AN ABLE BODIED PERSON DUE TO THE STRENUOUS PHYSICAL ACTIVITY THROUGHOUT THE DAY. |
| Can you help support someone’s weight getting in and out of a wheelchair |
Yes*No |
| Can you push a veteran in a wheelchair up an incline |
Yes*No |
| Can you push a wheelchair all day |
Yes*No |
| Can you lift 50 lbs. |
Yes*No |
| Guardians must be between 18-65. Exceptions must be approved by the EIHF Board of Directors. |
Are you between 18-65
It is preferred guardians be at least one generation removed. |
Yes*No |
| Spouses/Partners/Significant others cannot be a guardian |
| Are you a spouse, partner or significant other of a veteran on this flight? |
Yes*No |
| Guardians may be required to accompany up to three veterans. |
| Are you willing to serve as a guardian for more than one veteran if needed |
Yes*No |
| PLEASE NOTE ANY MEDICAL EXPERIENCE YOU MAY HAVE: (nurse, EMT, paramedic, etc.) |
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| Please identify any physical disabilities, restrictions and/or medical conditions that would limit your ability to fulfill the duties of aguardian. |
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| PLEASE REVIEW CAREFULLY AND ACKNOWLEDGE |
The undersigned acknowledges and agrees that:
1. As photographic and video equipment are frequently used to memorialize and document Eastern Iowa Honor Flight trips and events, his/her image may appear in a public forum, such as the media or a website, to acknowledge, promote or advance the work of the Eastern Iowa Honor Flight program. I hereby release the photographer and Eastern Iowa Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during an Eastern Iowa Honor Flight activities through video, photo, or other media, to be used solely for the purposes of Eastern Iowa Honor Flight promotional material and publications, and waive any rights or compensation or ownership thereto.
2. I further state that medical insurance is the responsibility of the veteran and I understand that Eastern Iowa Honor Flight does NOT provide medical care. I understand that I accept all risks associated with travel and other Eastern Iowa Honor Flight activities and will not hold Eastern Iowa Honor Flight responsible for any injuries incurred by me while participating in the Eastern Iowa Honor Flight program.
If you agree with our terms make sure you accept them by checking the box
I accept these terms Date:
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