Veteran Application - For Flights originating from Louisville

Honor Flight recognizes American Veterans for your sacrifices and achievements by flying you to Washington, DC to see YOUR memorial at no cost. Top priority (for which we are currently accpeting application only) is given to WW II and terminally ill Veterans from all wars.

For what you and your comrades have given to us, please consider this a small token of appreciation from all of us at Honor Flight.

Please fill out the digital application below, or click here for Printed Version (PDF) that can be mailed.

Honor Flight recognizes American Veterans for your sacrifices and achievements by transporting you at no cost to Washington, DC to visit YOUR memorial.

Top priority is given to Veterans from all wars diagnosed with a terminal illness and then to WW II Veterans who have never visited the memorials before.

Applications accepted for the waiting list will be applied on a first come first served basis sorted by war and then application date.

For Honor Flight to achieve this goal "QUALIFIED GUARDIANS" travel with Veterans on every trip, providing assistance and helping Veterans have a safe, memorable and rewarding experience.

For what you and your comrades have given to us, please consider this a small token of appreciation from all of us at Honor Flight. Thank you for our freedom.

NOTE: If you have already submitted an application, and you are returning to provide updated information, please do so under the Message section of the Contact form found at http://www.honorflightbluegrass.org/contact.

Thanks, your application has been submitted.

Veteran Information
Veteran Contact Information
Service History

Please specify your other service dates:

Emergency Contact

The Emergency Contact should be someone available on the day of the trip.

Alternate Contact

Son, Daughter, etc.

  Medical Information

INFORMATION PROVIDED WILL NOT DISQUALIFY YOU.

IT PERMITS US TO ASSESS THE SUPPORT WE NEED DURING THE TRIP; HOWEVER, IN THE BEST INTERESTS OF A VETERAN'S SAFETY AND SECURITY CIRCUMSTANCES MAY DICTATE THAT A VETERAN MAY BE REFUSED TO PARTICIPATE IN THE MISSION IF HE/SHE IS OBSERVED TO BE PHYSICALLY OR MENTALLY UNABLE OR INCAPABLE TO DO SO.

THIS INFORMATION IS FOR THE HONOR FLIGHT AND MEDICAL PERSONNEL ONLY AND WILL BE KEPT STRICTLY CONFIDENTIAL.

Other Information

PLEASE REVIEW CAREFULLY AND SIGN:

The undersigned acknowledges and agrees that:

  1. As photographic and video equipment are frequently used to memorialize and document 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 Honor Flight program. I hereby release the photographer and Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during Honor Flight activities through video, photo, or other media, to be used solely for the purposes of 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 Honor Flight does NOT provide medical care.
  3. I state that the scope and nature of the Honor Flight program and activities has been explained to me and I am physically and mentally able to travel and engage in the Honor Flight program and activities.
  4. I understand and accept all risks associated with travel and other Honor Flight activities and will hold Honor Flight, its agents, directors, members or assigns, harmless for any injuries I sustain or omissions which cause harm to me while participating in the Honor Flight program and activities, and expressly release them from any and all liability whatsoever. I expressly intend to bind my heirs by this release and waiver.
  5. I understand that participation involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I also understand that participation in the Honor Flight Network and/or the Honor Flight Bluegrass Chapter’s mission is entirely voluntary and requires participants to abide by applicable rules and standards of conduct.
  6. In case of an emergency, I understand that every effort will be made to contact the individual listed as the emergency contact person(s) for me. In the event that this person(s) cannot be reached, permission is hereby given to the medical provider selected by the Honor Flight Network and/or the Honor Flight Bluegrass Chapter to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me. Medical providers are authorized to disclose protected health information within the Honor Flight Network and/or any physician or health care provider involved in providing medical care to the participant.
  7. I have carefully considered the risk involved and give consent to participate.
  8. To safeguard the disclosure of your information entrusted by you to the Honor Flight Network and/or the Honor Flight Bluegrass Chapter:
    1. We shall not share, trade or sell your information without your permission, except as permitted or required by law.
    2. We shall keep your health information confidential. We shall not disclose your information without your permission, except as permitted or required by law.
    3. I approve the sharing of the information on this form within the Honor Flight Network and professionals who need to know of medical situations that might require special consideration for the safe conducting of its mission.
  9. You give the Honor Flight Network and/or the Honor Flight Bluegrass Chapter permission to verify your medical condition(s) with your physician(s).

IF YOU LISTED A QUALIFIED GUARDIAN THAT YOU WOULD LIKE TO ACCOMPANY YOU, THAT PERSON MUST ALSO FILL OUT A SEPARATE GUARDIAN APPLICATION ON THIS WEBSITE.