Costa Rica Application

costa-rica-header

Wildcat Water Polo
Costa Rica Trip Application
February 17-24, 2018

Fields marked with an * are required

General Personal Information

*If you do not have your passport, please write your name as it will appear in passport (your full legal name as it appears on your birth certificate).


Applicant Background

Although CULTURELink and SCORE International are Christian organizations, adhering to the Christian faith is not a requirement to go on this trip.


Education, Employment, and Volunteer Service


MEDICAL INFORMATION

Accurate medical info is vital should something happen on the field. Please be thorough.


REFERENCES

Please list two people that can provide a character reference for the trip leader(s) and sponsoring organizations. These references must be over 21 years old and cannot be family members. One of your references may be your water polo coach.


Team Commitment

Please read the items below carefully, then check the box next to each item to signify you agree with the statement.


Digital Signature

By filling in your name below, you are digitally signing this application. You are affirming that all of the information provided is accurate and complete. If the applicant is under 18 years old, the signature of a parent or legal guardian is required.


Additional Information and Paperwork

After you click submit, you will receive an email confirmation and a copy of the information you provided. If applicable, a copy will be send to the parent's email address you provided as well. After the applications have been received and reviewed, the team will be selected and every applicant will be notified.

Additional paperwork will be required after the team has been selected including:

  • Copy of Health Insurance Card
  • Parent Affidavit for Minors
  • Background Check Request for Adults
  • Medical Release / Waiver / Parental Consent for the host organization (SCORE International)
  • Behavioral Policy, Guidelines, and Procedures for the sponsoring organization (CULTURELink) and host organization (SCORE International)
  • If necessary, a physician's note approving travel.