Guardian Application - Hawaiian Islands Honor Flight

Personal Information

As it appears on your government-issued photo ID.

First Name *

Middle Name

Last Name *

If used (For Nametag)

Gender *

Email *

Cell Phone *

2nd Phone

Date of Birth *

Street Address *

City

State

ZIP Code *

Island *

Preferred Airport if living on Hawaii Island

Have you been a Guardian Previously?

Veteran Status & Requested Veteran

Veteran Status *

Yes No

Branch of Service

Select all that apply.

Air Force Army Coast Guard Marine Corps Navy National Guard Space Force

Years of Service

If you would like to travel as the Guardian for a specific veteran, provide their name below. Note: guardians must be a non-spouse/partner.

Requesting a Specific Veteran

Yes No

Veteran Name

Relationship to Veteran

Physical & Medical

T-Shirt Size *

Jacket Size *

Can you lift 50 pounds? *

Do you take medications? (You will be asked to provide a copy of type and dosage when screened by medical personnel) *

Mobility Devices? *

Cane Scooter Walker Wheelchair Wheelchair (wide) N/A

Emergency Contact

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

Emergency Contact Email

Additional Contact Name

Additional Contact Relationship

Additional Contact Phone

Guardian Fitness & Readiness

Guardian Requirements

Accurate information in this section allows our Leadership and Medical Teams to assess fitness to perform Guardian duties. As a Guardian, your duties will include the responsibilities listed below.

I confirm that I am able to: *

Physically assist a veteran through the airport, on/off buses, at the hotels, and during all memorial stops Push a wheelchair up to 6 miles over 3 days for a veteran weighing up to 350 pounds Lift and carry luggage that weighs up to 50 pounds Carry your luggage and your veteran's luggage through the airport Collapse, lift, and stow wheelchairs under a tour bus up to 10 times per day Assist your veteran in/out of bed, if necessary Maintain a POSITIVE ATTITUDE and a HEART OF SERVICE for the entire trip

Do you have breathing problems? *

Do you use any of the following? *

CPAP machine Home nebulizer Oxygen N/A

Please describe your breathing problems

Do you have any medication allergies? *

Please describe allergic reaction & treatment if known.

Please list allergies.

Are you diabetic? *

If Diabetic, how is your diabetes controlled?

Do you require special meals? *

Do you wear or have a heart pacemaker or defibrillator? *

Please list additional medical concerns.

Training, Documents & Agreement

I have watched the full Guardian Training Video and I am physically, mentally, and emotionally able to fulfill the duties of a Guardian as described in the video and this application. *

Document Uploads

Documents are required before trip approval but do not need to be uploaded now. You may also email them to [email protected]

Government-issued Photo ID

Images, PDF, or Word. Max 10MB.

Medical Certificate of Fitness

Not required at this time. A signed medical certificate will be requested once your trip is confirmed.

Indemnity Agreement

Please review and sign by checking the box below.

Indemnity Agreement

Photographs/videos are used to memorialize Honor Flight events. My image may appear in a public forum to promote or advance the work of Hawaiian Islands Honor Flight (Organization). I hereby release media and Hawaiian Islands Honor Flight from all claims and liability relating to said images. I hereby give permission for my image, captured during Honor Flight activities, to be used solely for the purpose of Honor Flight promotional materials and publications, and waive any rights, compensation, or ownership thereto.

I am voluntarily participating in various activities of Hawaiian Islands Honor Flight including flying on a commercial airline. I understand that Hawaiian Islands Honor Flight does NOT provide medical care. I understand that medical insurance is my responsibility. I understand that Hawaiian Islands Honor Flight does not provide medical or trip insurance. I accept all risks associated with travel and other Honor Flight activities and will not hold Hawaiian Islands Honor Flight responsible for destruction, loss, damage, or injury (to include death) to my person or property which may occur from any cause whatsoever as a result of my participation in the activities of Hawaiian Islands Honor Flight or the Honor Flight Network.

I further understand that Hawaiian Islands Honor Flight includes any members, officers, directors, volunteers, affiliated business entities and their shareholders, and assigns thereof.

I will follow all written, video, and verbal rules and directions provided by Hawaiian Islands Honor Flight leadership. I also agree to hold Hawaiian Islands Honor Flight parties not liable for libel, defamation, or slander. If Hawaiian Islands Honor Flight leadership believes, in their sole discretion, that I am not following rules and direction, that I am not representing the Organization with excellence, have been dishonest, committed fraud, or that I am behaving in an unsafe, inappropriate, or dangerous way, I will be expelled from the flight or activity and may be sent home immediately. Hawaiian Islands Honor Flight will not tolerate sexual harassment, aggressive verbal or physical behavior, or expression of political views or beliefs. Hawaiian Islands Honor Flight reserves the right to deny any application.

I will conduct myself in an honorable way during the entire flight.

I will treat fellow veterans, volunteers, and affiliated business entities/partners with professionalism, dignity, respect, and compassion.

I have answered each question on this application with honesty and integrity.

This Indemnity Agreement releases Hawaiian Islands Honor Flight from any liability, waives all claims against the Organization, and agrees to indemnify the Organization from liability in certain circumstances. Read carefully and make sure you fully understand and agree to each of the terms of this Indemnity Agreement before signing.

I have read, understand, and agree to the terms of this Indemnity Agreement. *

Mileage Program ID

How did you hear about Hawaiian Islands Honor Flight

Hawaiian Islands Honor Flight

Personal Information

Veteran Status & Requested Veteran

Need to take a break?

Physical & Medical

Emergency Contact

Guardian Fitness & Readiness

Training, Documents & Agreement

Document Uploads

Indemnity Agreement