Cultural Trip Forms – Institute of Study Abroad Ireland

Thank you for your interest in our upcoming trip. Please fill out the below forms to confirm your details.

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Name of your Trip

Please select your trip from the dropdown*

Trip Start Date*

Trip End Date*

Section One - Personal Information

First Name (As per Passport)*

Last Name (As per Passport)*

Preferred name if different from above

Gender/Preferred Pronouns

Home Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Contact Phone Number (Home)*

Contact Phone Number (Cell)

Email*

Date of Birth*

Please upload a recent headshot photo of yourself*

Accepted file types: jpg, jpeg, png, Max. file size: 2 GB.

Section One - Personal Information (Dietary Requirements & Medical info)

Please indicate any dietary requirements.

Vegetarian, Gluten Free and Vegan meal plans can be accommodated . FOOD ALLERGIES MUST BE RECORDED AND PARTICIPANTS MUST INFORM THE DIRECTORS AND MEAL PROVIDERS ON ARRIVAL OF ANY SEVERE ALLERGIES.

Please outline any medical conditions that may be relevant: Include any details of any medications required.*

Please indicate any allergies*

Please indicate anything else you feel is relevant under health. All information will be treated in strictest confidence.

Section 2: Statement of Due Warning and Assumption of Risk

Voluntary Participation Agreement*

I have been advised and am aware of the inherent and / or latent danger (including but not limited to: risk of serious injury, the hazards of travel, accident or illness, or acts of God) of participating in such an activity. I am aware and have been advised to have a medical examination prior to participating in this activity to ensure that I am in good physical health. I am aware that this program outdoor activities and there is a risk of accident or injury. Further, I am aware and have been advised that I must be properly covered by adequate travel insurance policy.

Program activities may include outdoor activities such as surfing, hiking, kayaking, swimming, team sports, moderate walking, options such as horseback riding, bodyboarding and other sporting activities. I understand that I am free to withdraw from any of these activities, but by participating, I have been advised and am aware of the inherent and / or latent danger (including but not limited to: risk of serious injury, the hazards of travel, accident or illness, or acts of God) of participating in such an activity.

I understand that this is a group program, and that group standards must be observed. I agree that THE INSTITUTE OF STUDY ABROAD IRELAND and the Director, Niamh Hamill shall have the right to terminate my enrolment for failure to maintain these standards, for actions or conduct which the Program and /or course director considers to be detrimental to or incompatible with the interest, harmony, comfort or welfare of the course and group as a whole. I understand that if I am asked to leave the program, I must bear responsibility for all costs including immediate return to USA. I understand that the Program and/ or course director reserves the right to change assignments and to make alterations in itineraries at any time without prior notice.

I have and do hereby note, understand, and assume all risks, which may arise from or in connection with this activity. The terms hereof shall serve as a release and assumption of risk for my heirs, executors, assigns and administrators and for all members of my family.

I voluntarily agree to participate in this Cultural Trip with Institute of Study Abroad Ireland Program

Signature*

Initials of Signee*

Signature Date*

Section 2: Consent Form For Emergency Treatment

Name of Emergency Contact*

Emergency Contact Home Telephone Number*

Emergency Contact Work Telephone Number*

Emergency Contact Address*

Doctor's Name*

Doctor's Contact Number*

Alternative Medical Contact

Emergency Consent

I consent to receiving emergency medical treatment if neccessary.

Section 3: Code of Conduct

Signature*

Initials of Signee*

Signature Date*

Section 4: Customs and Travel Documents

Please upload a picture of your flight transcript*

Max. file size: 2 GB.

Travel Policy*

All participants will receive an invitation letter for Customs in Ireland -this goes automatically to you when you send this application. Occasionally it goes to your junk folder- please check! We will send this to you. Please ensure you have this document with you when you travel. You will need a valid passport for your travel. .

If you are a passport holder of a country that is not the USA, please check this website https://www.dfa.ie/travel/ visas/visas-for-ireland/ for visa requirements.

For Covid-19 updates and travel advice to Ireland, please see : https://www.gov.ie/en/campaigns/75d92-covid-19travel-advice/

A personal travel insurance policy is a requirement of joining ISAI programs.

A personal travel insurance policy is a wise investment. You can insure yourself against any delays or cancellation in travel, and also you can insure yourself against trip disruption and cancellation. Air travel can be disrupted by weather events at any time of year, and by other events beyond control. If you become unwell or have an accident while travelling, you should have access to the best, immediate healthcare, or have the option to return home if you need to. Our experience is that few participants have the above issues, but if and when they do, this is when travel insurance is essential. Without travel insurance, healthcare, travel, and disruption can become extremely expensive, - with it, you can do what you need to do without this added worry. Both the USA Government and the Irish Government strongly recommend you do not travel without a personal travel policy. We will request a letter waiving our advice to a travel insurance policy if you do choose not to select travel insurance

Since 2020, we have made a personal travel insurance policy a compulsory element of an ISAI program. You can purchase a travel insurance policy from your own insurance provider, and airlines usually offer you a travel policy when you book flights. There are also many online sellers. If you are a frequent traveller, you may have an annual travel insurance policy, or have a family policy. Please check your cover includes Ireland, and includes trip cancellation or trip disruption.

ISAI can recommend LewerGlobal, and you can connect with them here :https://lewerglobal.com/study-abroad-ireland/

This policy is used with our usual participant groups, and will provide policies for professional development attendees.

I agree to the Travel policy.

Insurance Policy Number*

Insurance Provider*

Insurance Provider Address*

Signature*

Initials of Signee*

Signature Date*