EMAILS

© 2018 copyright AmericanWarrior | website by Kelsey Lynn Designs

General Information: warrior@americanwarrior.us

VETERAN APPLICATION

EMERGENCY CONTACT
SECOND EMERGENCY CONTACT
SERVICE HISTORY
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MEDICAL INFORMATION
Do you have drug allergies?
Do you have a breathing problem?
Do you require oxygen?
Do you have any open head wounds, sinus problems or ear problems?
Do you have a urostomy or colostomy bag? (If so please make sure the bag is vented prior to flight)
Do you have a history of seizures?
Do you have a walking problem, walking the length of a football field?
Do you have a portable nebulizer?
If yes, have you flown since the injury, sinus problem or ear problem?

PLEASE REVIEW CAREFULLY AND SIGN

The undersigned acknowledges and agrees that:

 

1. We will take pictures and video to document our trip to Washington DC. These

pictures may appear on our website or elsewhere. I hereby release the

AmericanWarrior.us from all claims and liability relating to said photographs. I

hereby give permission for my images captured during AW activities through

video, photo, or other media, to be used solely for the purposes of American

Warrior promotional materials and publications, and waive any rights or

compensation of ownership thereto.

2. I further state that medical insurance is the responsibility of the Veteran and I

understand that AmericanWarrior.us does not provide medical care. I understand

that I accept all risks associated with travel and other AW activities and will not

hold American Warrior responsible for any injuries incurred by me while

participating in their program.