Enrollment Application

1 Student Info

2 Parent /Guardian Info

3 Adventure Info & Terms

4 Insurance & Deposit

5 Review & Submit

1. Student Information

Student Details
Legal First Name*
Middle Name
Legal Last Name*
Preferred Name / Nickname
Email*
Phone*
Phone Type*
Date of Birth*
Date Format: MM slash DD slash YYYY

Be sure to select the correct year
Country of Citizenship*
As defined by the passport you travel with
Sex (as shown on your travel documents)*
Gender
- Please select if you identify as another gender
What gender do you identify with?
Height*
T-Shirt Size*
Please note that these are male sizes, so adjust for females
Weight (in lbs)*
Please enter a number from 70 to 300.
Need help converting weight into LBS?
- Click for chart
Weight Converter
How did you first learn about ActionQuest?*
Please be specific
Student Home Address

We mail all correspondences to this address prior to, and after the program. This address should be valid for a minimum of 3 months after your adventure ends.
Street Address 1*
Street Address 2
City*
State/Province*
Zip/Postal Code*
Country*
School Information
Current Grade*
Name and location of student's current school*
Your Previous Experience
1. Scuba: Will you be certified or have a referral by summer?*
- Yes
- No
What scuba certifications will you have?*
2. Sailing: Do you have any experience?*
- Yes
- No
Tell us a little about your sailing experience.*
Medical Information
1. Does the student have any health considerations, allergies or disabilities we should be aware of?*
- Yes
- No
Please use the field below to give us a sense of these considerations.

We're not necessarily looking for a full medical history at this point (a completed medical form is required for all students before the program), yet we use the information you give us now to help determine whether the trip selected is appropriate and that the student has a high likelihood of success. For example, certain respiratory or pulmonary complications may restrict the ability to scuba dive, or acute allergic reactions to common food items can be a concern given our remote location.
Enter your information here.*
2. At any point in the last 12 months has the enrolling student been under the care of a therapist, psychiatrist or psychologist?*
- Yes
- No
The very nature of an AQ Adventure creates a living, social, and working dynamic that is very different from the home environment. For this reason, if the student has been under the care of a therapist, psychiatrist, or psychologist at any point in the last 12 months, we ask that the Counseling Professional complete a specific questionnaire. Exceptions to this requirement may be alumni who have previously submitted this form and been accepted.

Please enter an address below, and we will email you the Counseling Questionnaire along with some more information.
Email*

Save and Continue Later

2. Parent / Guardian Information

Please provide us with as much information as you can.
I can provide contact information for*
First Parent / Guardian Information
This information is for my:*
Relationship*
Title
First Name*
Last Name*
Email*
Primary Phone*
Phone Type*
Secondary Phone
Phone Type
- Click to autofill the mailing address you entered on step 1
Street Address 1*
Street Address 2
City*
State/Province*
Zip/Postal Code*
Country*
Second Parent / Guardian Information
This information is for my:*
Relationship*
Title
First Name*
Last Name*
Email*
Primary Phone*
Phone Type*
Secondary Phone
Phone Type
- Click to autofill mailing address from parent/guardian 1
Street Address 1*
Street Address 2
City*
State/Province*
Zip/Postal Code*
Country*

Save and Continue Later

3. Adventure Selection, Terms & Agreements

a. Adventure Selection
Primary Adventure*
Your adventure selection is not valid. Please reselect a valid adventure from the list above.
Enrollment for our 40 & 50-day Eastern Seaboard Voyage is by invitation only until October 15th, 2019. If you are enrolling during this period please enter your invitation code to continue.

Open enrollment will commence on October 15, 2019 - If you would like to be considered for a position on the team or have general questions, please call our office at +1.941.924.6789 EST.
Invitation Code*
Please enter your invitation code above
Thanks for entering the code - Please continue your application, the code will be verified upon submission
If this Adventure is full, would you like to select a backup option?*
- Yes
- No
Back Up Adventure*
Your adventure selection is not valid. Please reselect a valid adventure from the list above.
Are you applying for two AQ Adventures this summer?
- Yes
- No
Secondary Adventure*
Your adventure selection is not valid. Please reselect a valid adventure from the list above.
b. Terms Agreement & Participant Agreement

Read the following carefully. These documents contain important information and may affect your legal rights if an injury or other loss occurs.
Will the participant be UNDER the age of 18 at any time during the selected voyage?*
Once we have processed the enrollment application and created a student portal, the student will be asked to generate and sign a digital version of these agreements. In the meantime, feel free to download a copy by clicking here https://www.actionquest.com/release.
Once we have processed the enrollment application and created a student portal, you will be asked to generate a digital version of these agreements, which must be signed by BOTH student and parent/guardian. In the meantime, feel free to download a copy by clicking here https://www.actionquest.com/release.
Terms Agreement - Including Enrollment, Payment, Refund, Cancellation and Dismissal Agreements; Medical Authorization & Expense; Authorization to Use Images of Participant; Dispute Provisions
ActionQuest LLC, individually and d/b/a Global Expeditions Group, GoBeyond Student Travel, and Sea|mester (collectively, “GXG”), operate international adventure and service educational programs (“Programs”) for middle school, high school, and college students, and adults, under the brand names ActionQuest, GoBeyond, and Sea|mester. Please read this document completely and carefully. This Participant Terms Agreement (“Agreement”) sets forth the terms of the Participant’s enrollment in a GXG Program. This Agreement must be signed by all Participants, and a Parent or legal guardian if the Participant is a minor. “Participant” includes adult and minor Participants, unless indicated otherwise. “Parent” includes a parent or legal guardian of a minor Participant. In consideration of the services provided in the Programs, I agree, for myself (and for the minor Participant if I am signing as a Parent), to the following: Enrollment, Payment, Refund, Cancellation and Dismissal Terms: Most Participants enroll early to ensure a space in the Program of their choice, yet there is no set application deadline. To enroll, complete and return this application with the application deposit fee to GXG. The deposit will hold your space until the first half of tuition is due. For all Summer Programs, the standard application deposit is $750 before April 1 and $1,500 on/after April 1. This deposit is fully refundable until January 1 in the year of your Program. After that date, the deposit and all subsequent tuition payments are non-refundable, so we strongly suggest participants purchase trip cancellation insurance coverage. On March 1, one-half of the tuition is due to secure your space up until the final tuition payment due date. The tuition balance is due April 1. Applications are accepted after these dates where space is available. A $100 late fee will be applied to any tuition balance outstanding on May 1. Payment and late-fee extensions are available for applications after these deadline dates, so please call for details. Tuition payments are accepted by check, ACH, or wire transfer. Credit cards may also be used for tuition payments, but the tuition amounts will be slightly higher, as our published tuition fees reflect a 3% discount for payment by check, ACH, or wire transfer. Once enrolled, any request to switch Programs in the same summer will be considered on a case-by-case basis. GXG does not allow Program switches within 30 days of the Program’s start date. If any Program is canceled prior to commencement, GXG shall have no liability beyond the refund of deposits and monies paid directly to GXG. GXG will make reasonable efforts to accommodate Participants on another GXG Program. It is understood and agreed that any Program’s route and itinerary, facilities, personnel or activities may be changed at GXG’s sole discretion, without prior notice to Parents/Participations or any legal obligation to GXG. Except for flight irregularities, failure to arrive on the designated Program’s start date will be considered a cancellation unless previously approved by GXG. It is understood that GXG reserves the right to dismiss the participant from a course if it believes, in its sole discretion, the Participant: presents a safety concern or medical risk; is disruptive; breaches (or is associated with those in breach of) any agreement with GXG including the Student Code of Conduct; fails to meet GXG’s Student Essential Eligibility Criteria following a misrepresentation on an application form; or conducts him or herself in a manner detrimental to GXG or other participants. Participant/Parent is solely responsible for all costs of early departure whether for medical reasons, dismissal, personal emergencies, or otherwise. These costs include, but may not be limited to plane, train, or bus fare, and meals or accommodations for the departing Participant and any necessary Staff Chaperone. Parents (or designee authorized to make decisions) must be reachable at all times throughout the Program to coordinate the return of their Participant on the same day as a medical emergency or dismissal occurs. Enrollment for any two GXG Programs in the same summer will be considered a single program in the event of withdrawal or dismissal. Please Note: Information on Trip Cancellation Insurance is available on our website; subject to certain exclusions and conditions, the insurance offers a full refund for a small percentage of the amount insured in the event of cancellation up to departure and including interruption after departure. We strongly recommend that insurance is purchased to mitigate any loss after fees are paid. GXG reserves the right to cancel applicants, without refund, who have not fully paid by the applicable deadlines, and to accept others into the Program. By signing this Agreement, Participant and/or Parent agree to all terms, conditions and policies published on our website, and registration and application forms, including but not limited to the Participant Agreement and this Participant Terms Agreement. Medical Authorization & Expense: Participant and/or Parent authorize GXG staff or other medical personnel to obtain or provide medical or other health care for Participant, to transport Participant to a medical facility, and/or to provide treatment they consider necessary for Participant's heath. Participant and/or Parent agree to the release (to or by GXG) of any records necessary for treatment, referral, billing or insurance purposes. Reasonable efforts will be made to contact a Parent or emergency contact if a medical emergency or serious illness occurs. The cost of all health care services provided to the Participant, and any costs incurred by GXG staff while accompanying the Participant in the event of illness or injury, including lodging, transportation and costs related to rejoining the group, shall be paid by the Participant and/or Parent. Equipment Usage: If Participant is borrowing or renting new or used equipment from GXG, the equipment comes "AS-IS." GXG disclaims all warranties, express or implied (including any conditions of merchantability or fitness for a particular purpose), regarding the equipment. Authorization to Use Images of Participant: Participant and/or Parent authorize GXG and/or its agents and designees, to photograph, film, record and/or otherwise capture the name, image, voice, written statement, group journal or electronic entry, photograph and/or visual likeness of the Participant and his/her other family members (collectively “images”), without compensation, for use in any media throughout the world in perpetuity, including for sale, reproduction or display on the internet, in publications and/or for any informational, promotional, educational, audiovisual, exhibition, editorial, or other use in any manner that GXG desires. These images are the sole property of GXG, and Participant and/or Parent waive any inspection or approval rights. Dispute Provisions: If Participant or Parent has any dispute with GXG, its owners, employees, agents, staff, trustees, contractors, officers and directors, and the owners and operators of any vessel on which the Programs are conducted (collectively, “Released Party/ies”) arising out of or in any way connected with enrollment or participation in any of the Programs, the Parties will first attempt to resolve the matter through discussions between the Parties. If the issue cannot be resolved through discussions between the Parties, prior to the filing of any lawsuit, the Parties shall in good faith engage in pre-suit mediation before a mediator certified by the Florida Supreme Court. This Agreement, and any lawsuit or dispute in any way connected with Participant’s enrollment or participation in any of the Programs, shall be exclusively governed by the laws of Florida. This Agreement shall not be construed for or against a party because that party drafted it. The exclusive venue of any action or proceeding in any way related to, arising out of, or connected with a Participant’s enrollment or participation in any Program shall be the Middle District of Florida, Tampa Division, if the claim is subject to federal jurisdiction; and Sarasota County, Florida, if none of the claims are subject to federal jurisdiction. The Parties hereby waive the right to a jury trial in any action or proceeding under this Agreement or in any way arising out of, related to, or connected with the Participant’s enrollment or participation in any of the Programs, regardless of the legal theory of a cause of action. No party against whom an action is brought under this Agreement shall be liable for consequential or punitive damages. If GXG or any Released Party prevails in any lawsuit or claim against Participant and/or Parent, Participant and/or Parent agree to pay all costs, expenses and attorney’s fees incurred by GXG or any Released Party in any such lawsuit or claim. Participant and Parent acknowledge that this Agreement is intended to be interpreted and enforced to the fullest extent allowed by law. If any clause, or portion of a clause, in this Agreement is deemed to be invalid, it shall be regarded as stricken while the remainder of this Agreement shall continue to be in full force and effect. PARTICIPANT AND/OR PARENT OF A MINOR PARTICIPANT AGREE: I HAVE CAREFULLY READ, UNDERSTAND, AND VOLUNTARILY SIGN THIS DOCUMENT AND ACKNOWLEDGE THAT IT SHALL BE EFFECTIVE AND LEGALLY BINDING UPON ME, MY SPOUSE, PARTICIPATING CHILD AND OTHER CHILDREN, AND PARTICIPANT’S/PARENT’S OTHER FAMILY MEMBERS, HEIRS, EXECUTORS, REPRESENTATIVES, SUBROGEES, ASSIGNS, AND ESTATE. ALL PARTICIPANTS MUST SIGN BELOW. IF PARTICIPANT IS A MINOR (THOSE UNDER 18 YEARS OF AGE), ONE OF THE PARTICIPANT’S PARENTS OR LEGAL GUARDIANS MUST ALSO SIGN BELOW. I understand that my signature is valid and legally binding whether I choose to electronically sign or sign a printable version of this Document.
Participant, please check the box below to indicate your agreement with the Terms Agreement outlined above.*
- Participant agrees to the Terms Agreement
Parent, since the Participant will be under the age of 18 or some or all of the voyage, please check the box below to indicate your agreement with the Terms Agreement outlined above.*
- Parent agrees to the Terms Agreement
Participant Agreement - Including Declaration of Activities and Risks, Acknowledgment and Assumption of Risks & Liability Release and Indemnity
THIS DOCUMENT CONTAINS A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS. ActionQuest LLC, individually and d/b/a Global Expeditions Group, GoBeyond Student Travel, and Sea|mester (collectively, “GXG”), operate international adventure and service educational programs (“Programs”) for middle school, high school, and college students, and adults, under the brand names ActionQuest, GoBeyond, and Sea|mester. The Programs involve activities that have inherent risks, many of which cannot be eliminated without destroying the unique character of the activities. These risks, inherent and otherwise, can cause harm, injury, or loss to property and persons, and in extreme cases, severe injury or death. This document describes some of the risks. Please read this document completely and carefully. This Participant Agreement (“Agreement”) must be signed by all participants, and a parent or legal guardian if the participant is a minor. “Participant” includes adult and minor participants, unless indicated otherwise. “Parent” includes a parent or legal guardian of a minor Participant. In consideration of the services provided in the Programs, I agree (for myself and for the minor Participant if I am signing as a Parent) to the following: DECLARATION OF ACTIVITIES AND RISKS The Programs are conducted internationally, primarily near or on the sea, in many locations as described in program-specific materials furnished to Parents and Participants. GoBeyond includes more activities onshore as opposed to on the sea; ActionQuest and Sea|mester include more activities on the seas as opposed to onshore. Activities conducted onshore will occur in urban or rustic village settings. Programs may use chartered and rented sail and motor vessels of various sizes and capabilities. Activities vary among the Programs and may include the following: 1. Water sports activities may include but are not limited to sailing, scuba and snorkeling, swimming, whitewater rafting, waterskiing, wakeboarding, kneeboarding, windsurfing, surfing and operating small, motorized watercraft. In many programs, Participants will be subject to the risks of living and working on, and otherwise moving about, ocean-going vessels and other watercraft. Shipboard duties include but are not limited to raising, lowering and handling of sails; easing and grinding of working lines under load using winches and purchase systems; handling anchor lines, anchor chains and anchors; handling lines leading to small craft in tow from the deck of the vessel; cooking on gas stoves; cleaning of galley ware, common spaces, cabins and bathrooms. 2. Shore activities include transportation to and from activities and airports by way of airplane, taxi, train, public bus or rented vehicle. Other shore activities include but are not limited to exploring local cities, towns and villages during free time; hiking; camping; zip-lining; horseback riding; and, on rare occasion (only for Sea|mester), Participants over the age of 18 may ride scooters and/or operate other motorized vehicles. 3. Community service projects occur both onshore and off-shore and may expose Participants to risks ordinarily associated with light construction, including but not limited to heavy lifting and the use of potentially dangerous hand tools and power tools. Many of the activities include interaction with local populations. I UNDERSTAND THAT THE RISKS OF THE PROGRAMS INCLUDE, WITHOUT LIMITATION: 1. Weather, environmental, and surface and subsurface conditions in an outdoor or wilderness environment in a foreign country that are unpredictable and dangerous, including risks associated with travel on trails or routes that may not be groomed, maintained, controlled, or marked; lightning; snow or ice accumulation; high altitude conditions; fast moving rivers or other water bodies; falling or fallen timber; mineshafts; rockfall; icefall; steep or slippery terrain; electrical storms; mountain storms; flashfloods; snow; rain; hail; sleet; ice and extremely cold water; geothermal geysers or geothermally heated (extremely hot) water; unstable or loose rock; wild or domestic animals; stinging, venomous and/or disease carrying animals, insects or microorganisms; and other natural and man-made hazards and dangers; 2. Participant’s mental, physical or emotional condition (including use or abuse of alcohol or any prescription or non-prescription drugs), disclosed or undisclosed, known or unknown, combined with participation in the Activities, includes risks. Although GXG will review Participant’s submitted medical information, GXG cannot anticipate or eliminate risks or complications posed by Participant’s mental, physical (including fitness level) or emotional condition; 3. Risks associated with GXG staff decision-making, judgments, and warnings, which are often based on a variety of perceptions and evaluations, which by their nature are imprecise and subject to error. These include the risk that a staff member may misjudge an individual’s capabilities, health, or fitness level, or misjudge terrain, weather, trail location and conditions, water-level, ocean conditions, river and/or terrain route location, some aspect of instruction, medical treatment, the character and propensities of an animal, or how best to react in certain circumstances; 4. Risks associated with sailing, boating, surfing, sea kayaking, snorkeling, and scuba diving in an ocean or other open body of water, including interactions with other individuals and vessels on the water; potential hazards including docks, piers, bridges, buoys, rocks, corals, reefs, and the shore; water and weather conditions including tides, waves, and currents; equipment and gear malfunction; mechanical failures; the possibility of capsizing; interactions with fish, sharks, turtles, insects, and other animals; the unpredictable forces of nature, including weather, which may change the conditions from routine to extreme without notice; risks associated with Personal Flotation Devices; and otherwise being in a large body of water where a lifeguard is not present; accidents or collisions with other water craft; slipping, tripping, and falling on wet and slippery surfaces; and falling overboard; 5. Risks associated with home stays and residing with unknown people in a foreign, undeveloped country, including exposure to unfamiliar food, water, and animals; risks associated with varying and unfamiliar cultural norms; unanticipated verbal and physical harm; the careless or reckless behavior of other people; the possibility of inadvertent touching or unwanted sexual advances; and personal disclosure and/or interaction with such people. NOTE: Participants will be living and engaging in activities of daily living, including but not limited to sleeping, dressing, and showering, in close quarters with staff and other participants. Participants will be exposed to staff and other participants of diverse backgrounds including varying genders, races, religions, national origins, political views, and sexual orientations. 6. Animals, including without limitation, horses, donkeys, camels, or elephants are unpredictable and uncontrollable in all circumstances, whether participants are mounting, dismounting, saddling, feeding, riding, packing, or otherwise dealing with animals in any way. Animals are generally much larger, more powerful, and faster than a human, and can react to the environment, and the conduct and actions of riders and other persons in harmful ways. Without warning, animals can kick, bite, stomp, stumble, rear, bolt, fall, and react to sudden movements, noise, light, vehicles, other animals, or objects. Riding animals can involve equipment that may break or otherwise fail, saddles or blankets that may slip, and other riders who may not control their animals and cause a collision or other unpredictable consequences; 7. Risks of camping, including the risk of tending to, being near, or cooking over an open fire or gas or propane stove that is subject to a gas explosion, scalding, or other burns. Other risks include the risk of falling trees and/or branches, floods, harsh and unpredictable weather, wildlife disturbances and encounters, insect bites, and other hazards at a camp site; 8. The risk that equipment or gear may be misused, may not fit, or may break, fail, or malfunction. This includes Participant’s personal equipment, GXG equipment, or other equipment (whether purchased, borrowed, or rented). Participants choosing to bring and use their personal equipment (including any safety gear), assume full responsibility (along with their Parent), for choosing appropriate equipment and for the fit and condition of this equipment. GXG requires use of helmets, Personal Flotation Devices, or other safety gear for some activities. Safety gear may prevent or lessen injuries in some instances, but it is not a guarantee of safety, and injury can occur even if gear is used; 9. The unavailability of immediate and quality medical attention or rescue possibilities in an isolated and remote location, including the limited ability to communicate with rescue and medical personnel, and to transport or evacuate a participant from an incident location. Activities may take place on the open sea and onshore locations as much as several hours or days from any medical facility, and in regions where traditional Western medical care is not always available; 10. Risks associated with high and low challenge course elements and zip-lines which may be as high as 50 feet off the ground, including the possibility of falling a large distance, slipping, rope burns, pinches, jolts, splinters or swaying, colliding with other participants, and experiencing anxieties and fears associated with heights; 11. Risks from participating in a physically exerting activity in an unpredictable environment, including engaging in repetitive arm and leg movements, bending, walking, riding, twisting, pulling, lifting, running, jumping, climbing, and sustaining back and other injuries as a result of using a shovel, hammer, machete, pick-axe, or other tool; 12. Risks associated with rafting, kayaking, or canoeing in a creek or river including encountering swift or cold water; the presence of unknown obstacles such as rocks or timber; the risk that a vessel may overturn or sink; and risks associated with Personal Flotation Devices, including that it does not properly fit, it may not be available, is not properly secured, or contains a defect that may impact its ability to function; 13. Risks associated with interactions with, and reliance on, GXG, other participants, contractors, or unknown third parties, including the careless or reckless behavior of other people, the possibility of inadvertent touching or unwanted sexual advances, and personal disclosure and/or interaction with co-participants; 14. Risks of traveling in foreign countries, including being transported in vehicles on undeveloped, rough, mountainous and unpredictable terrain, including dangerous roads, bridges, and other infrastructure; the risks of driver error either by individuals affiliated with a third-party carrier or drivers of other vehicles; the risk of vehicle malfunction and travel in potentially unsafe vehicles including buses not equipped with seat belts; vehicular accidents or collisions; exposure to poor sanitation and contaminated foods or water, and unusual diseases; and encounters with terrorism, war, kidnapping, political unrest, riots, individuals with anti-American sentiment, and other forces or harm; and 15. Risks associated with participants having free and/or independent time before, during, and after activities. At all times, all participants share in the responsibility for their own wellbeing. These risks may result in damage to property, bodily injury, lacerations, contusions, broken bones, spinal injuries, head injuries, infectious diseases, emotional injuries, psychiatric/psychological injuries, exposure to the sun and other elements, water immersion and drowning, serious bodily injury, or even death. The risks of the Programs’ activities, described above, is not exhaustive and other risks may exist. These activities may require a degree of skill and knowledge different from other activities of which Participants may be more familiar. Participants are responsible for managing the risks to themselves and others. Participant and Parent acknowledge that participation in the Program is purely voluntary and is being done with full knowledge of the inherent and other risks. I understand GXG contracts with independent contractors for certain services including ground transportation, Sunsail/Moorings for the yacht charter, and in some locations outside of the British Virgin Islands, scuba diving. These contractors are not supervised or controlled by GXG and they are solely responsible for their conduct. Some independent contractors, including but not limited to PADI, may require execution of certain documents, including releases of claims against them. Such documents pertain to those contractors and not to GXG. ACKNOWLEDGMENT AND ASSUMPTION OF RISKS Please read carefully. This Acknowledgement and Assumption of Risks contains a surrender of certain legal rights. I hereby declare that I have carefully and completely read the above Declaration of Activities and Risks before signing this Agreement. Understanding and acknowledging the activities and risks of each Program, I certify that the Participant is physically, emotionally, and mentally capable of participating in the chosen Program, without causing harm to himself, herself, or others. I further certify that before the Program commences, I will inform GXG of all past or current physical, emotional, and/or psychological conditions that might adversely affect the Participant’s participation in the chosen Program. I agree to honestly and accurately complete all GXG registration forms (including medical forms) and obey all rules and policies. In consideration of the services provided by GXG, I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, and on behalf of my child (if the Participant is a minor), understand and agree as follows: I understand that the activities associated with the Programs have inherent risks, many of which cannot be eliminated without destroying the unique character of the activities. I understand and acknowledge the nature of the activities and the dangers and risks associated with participation in any of the Programs, which are described in the above Declaration of Activities and Risks. I also understand and acknowledge that the information provided above is not complete, other unknown or unanticipated activities, risks, and outcomes may exist, and GXG cannot assure the Participant’s safety or eliminate any of these risks. With full understanding of the dangers and risks involved, I, on behalf of myself and on behalf of my child (if the Participant is a minor), hereby assume all risks of participating in the activities of any of the Programs, including any harm, injury, loss or even death, caused by the negligence of GXG, its owners, employees or agents, staff, trustees, officers and directors, contractors, third parties, or other Participants participating in any of the Programs. If the Participant is a minor, the Parent also certifies he or she has discussed the activities and risks with the minor Participant who nonetheless chooses to participate. LIABILITY RELEASE AND INDEMNITY AGREEMENT I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, and on behalf of my child (if the Participant is a minor), hereby release, hold harmless, and agree not to make any claims or to sue GXG, its owners, employees, agents, staff, trustees, officers and directors, contractors, and the owners and operators of any vessel on which the Programs are conducted (collectively, “Released Parties”) from any and all claims of harm, injury, loss or even death that I, or my child (if the Participant is a minor), may suffer arising out of or in any way connected with enrollment or participation in any of the Programs. THIS RELEASE, HOLD HARMLESS AND AGREEMENT NOT TO MAKE ANY CLAIMS OR TO SUE INCLUDES, BUT IS NOT LIMITED TO, ANY AND ALL CLAIMS OF HARM, INJURY, LOSS OR DEATH THAT IS CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF ANY OF THE RELEASED PARTIES. AMONG OTHER THINGS, I SPECIFICALLY UNDERSTAND THAT BY SIGNING THIS AGREEMENT, I AM AGREEING TO RELEASE THE RELEASED PARTIES (INCLUDING, BUT NOT LIMITED TO, GXG) FROM ANY LIABILITY RESULTING FROM ANY OF THE RELEASED PARTIES’ NEGLIGENCE. I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, and on behalf of my child (if the Participant is a minor), agree further to indemnify the Released Parties from any claim, demand, or suit brought by me, by or on behalf of the Participant (if the Participant is a minor), or anyone else, alleging harm, injury, loss or death arising out of or in any way related to my, or my child’s (if the Participant is a minor) enrollment or participation in any of the Programs. I AGREE TO THE TERMS OF THIS INDEMNITY, EVEN IF SUCH HARM, INJURY, LOSS OR DEATH WAS CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF ANY OF THE RELEASED PARTIES. “Indemnify” means to defend, and to pay or reimburse the Released Parties for all expenses, including costs and attorney’s fees. I understand that Florida law may limit my authority to execute a release on behalf of a minor child. I make the release and indemnity only to the extent that Florida law permits. If any clause, or portion of a clause, in this Agreement is deemed to be invalid, it shall be regarded as stricken while the remainder of this Agreement shall continue to be in full force and effect. This Agreement shall not be construed for or against a party because that party drafted it. IF THE PARTICIPANT IS A MINOR AT ANY TIME DURING A PROGRAM, FLORIDA LAW REQUIRES THAT THE FOLLOWING STATEMENT BE PROVIDED IN UPPERCASE TYPE, AT LEAST 5 POINTS LARGER THAN, AND CLEARLY DISTINGUISHABLE FROM, THE REST OF THE TEXT OF THE WAIVER OR RELEASE. SECTION 744.301, FLORIDA STATUTES (2018). NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF THE RELEASED PARTIES USE REASONABLE CARE IN PROVIDING THESE ACTIVITIES, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THESE ACTIVITIES BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THESE ACTIVITIES WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM THE RELEASED PARTIES IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THESE ACTIVITIES. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASED PARTIES HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. PARTICIPANT AND/OR PARENT OF A MINOR PARTICIPANT AGREE: I HAVE CAREFULLY READ, UNDERSTAND, AND VOLUNTARILY SIGN THIS DOCUMENT AND ACKNOWLEDGE THAT IT SHALL BE EFFECTIVE AND LEGALLY BINDING UPON ME, MY SPOUSE, PARTICIPATING CHILD AND OTHER CHILDREN, AND PARTICIPANT’S/PARENT’S OTHER FAMILY MEMBERS, HEIRS, EXECUTORS, REPRESENTATIVES, SUBROGEES, ASSIGNS, AND ESTATE. ALL PARTICIPANTS MUST SIGN BELOW. IF PARTICIPANT IS A MINOR (THOSE UNDER 18 YEARS OF AGE), ONE OF THE PARTICIPANT’S PARENTS OR LEGAL GUARDIANS MUST ALSO SIGN BELOW. I ACKNOWLEDGE THAT THIS AGREEMENT IS INTENDED TO BE INTERPRETED AND ENFORCED TO THE FULLEST EXTENT ALLOWED BY LAW. I understand that my signature is valid and legally binding whether I choose to electronically sign or sign a printable version of this Document.
Participant, please check the box below to indicate your agreement with the Participant Agreement outlined above.*
- Student Participant agrees to the Participant Agreement
Parent, since the Participant will be under the age of 18 or some or all of the voyage, please check the box below to indicate your agreement with the Participant Agreement outlined above.*
- Parent agrees to the Participant Agreement

Save and Continue Later

4. Insurance & Deposit

a. International SOS Membership & Emergency Evacuation Insurance (required)

Because we want to be prepared for every scenario, we've partnered with International SOS, the world's leading medical and security risk services company to provide complete emergency evacuation coordination and insurance for our students. A critical piece of this plan is that International SOS membership also provides 24/7 access to a robust network of doctors and security services both before and during the trip. The cost of the membership is $70 per student for Adventures up to 21-days and $100 for 40 and 50-day trips. While we understand that this is an additional fee, we believe our students and their families will appreciate the value of International SOS's services along with the peace of mind that this resource brings. We will add the membership fee as a separate item on your tuition invoice, and prior to the program we'll send all of your International SOS membership details.

Please note that this is not Tuition or Medical Insurance. Those seeking to protect their tuition investment should consider the optional insurance packages outlined below.

b. Tuition & Medical Insurance (Optional)

Life is uncertain, so it’s important for students and parents to consider protecting their tuition investment. Purchasing Tuition & Travel Protection Insurance provides coverage for unexpected travel emergencies including certain medical benefits, airline and trip interruption coverage. In many cases, you can also select a Cancel For Any Reason policy that allows an additional degree of flexibility should your plans change before the summer.

Options differ depending on where you live, so start by selecting your residency to learn more.
I am a:*
This TripMate insurance package contains a "Cancel for any reason" provision and is available for U.S. residents of all states other than New York. Benefits include*:
- Trip Cancellation – Covers 100% of your trip cost for cancellation "covered" reasons such as injury etc
- Cancel for Any Reason – If you cancel your trip for any reason not otherwise covered by this policy, TripMate will reimburse you for 75% of the unused non-refundable prepaid expenses for your trip.
- Trip Interruption – Covers up to 125% of your trip cost if your program is interrupted.
- Medical Expenses - Covers for accident and sickness medical expenses up to $100,000 USD.
- Baggage – Up to $1000 for damage, lost, or stolen personal articles.
*Please Note that TripMate may change their benefits relative to COVID-19 based on the date of plan purchase. Please visit http://www.TripMate.com for more infomation.

Learn more about TripMate plans on our website here HERE
The cost of this policy is $360 USD per trip, and is highly recommended.*
- Yes, enroll me for tuition protection insurance. I wish to insure my investment for $360
- No, do not enroll me for tuition protection insurance. I am declining to insure my investment at this time. (not recommended)
The cost of this policy is $638 USD, and is highly recommended.*
- Yes, enroll me for tuition protection insurance. I wish to insure my investment for $638
- No, do not enroll me for tuition protection insurance. I am declining to insure my investment at this time. (not recommended)
This TripMate insurance package is designed specifically for U.S. New York residents and provides coverage for unexpected travel emergencies. Benefits include*:
- Trip Cancellation – Covers 100% of your trip cost for cancellation reasons such as injury etc
- Trip Interruption – Covers up to 125% of your trip cost if your program is interrupted.
- Medical Expenses - Covers for accident and sickness medical expenses up to $100,000 USD.
- Baggage – Up to $1000 for damage, lost, or stolen personal articles.
*Please Note that TripMate may change their benefits relative to COVID-19 based on the date of plan purchase. Please visit http://www.TripMate.com for more infomation.

Learn more about TripMate plans on our website here HERE
The cost of the policy is $250 USD per trip, and is highly recommended.*
- Yes, enroll me for tuition protection insurance. I wish to insure my investment for $250
- No, do not enroll me for tuition protection insurance. I am declining to insure my investment at this time. (not recommended)
The cost of the policy is $425 USD and is highly recommended.*
- Yes, enroll me for tuition protection insurance. I wish to insure my investment for $425
- No, do not enroll me for tuition protection insurance. I am declining to insure my investment at this time. (not recommended)
This TripMate insurance package is designed specifically for Canadian residents, and provides coverage for unexpected travel emergencies including the following.
- Trip Cancellation Up to 100% Trip Cost
- Trip Interruption Up to 100% Trip Cost
- Accident and Sickness Medical Expense $1,000,000
- Travel Delay $1,000 ($150/day - 12 hours)
- Missed Connection $750 (3 hours)
- Baggage & Personal Effects $1,500
- Baggage Delay $500 (12 hours)
- Pre-Existing Conditions Exclusion waiver if purchased within 21 days of deposit
Click HERE to launch a separate browser window and create a quote. Alternatively, information is available on our website at actionquest.com/trip-insurance.
We recommend you consider an insurance policy through Abroad Insurance that offers worldwide coverage for non-US residents. This information is on our website and will be provided in an email to you upon request. Alternatively, click HERE to learn more.
b. Deposit Details & Payment Authorization

Authorization for a one-time charge to your credit card to pay the application deposit and Tuition & Travel Protection Insurance (if selected) according to the Terms and Agreements. Standard deposit is $750 USD when enrolling through March 31, then $1500 USD on/after April 1.
Primary Trip Deposit
Price: $1,500.00
Secondary Trip Deposit
Price: $1,500.00
NY State Resident Insurance Policy
Price: $250.00
NY State Resident Insurance Policy - Second Trip
Price: $250.00
NY State Resident Insurance Policy
Price: $425.00
USA Insurance Policy
Price: $360.00
USA Insurance Policy - Second Trip
Price: $360.00
USA Insurance Policy
Price: $638.00
Total
Will be charged to your credit card
$0.00
d. Discount / Scholarship Code
- Click here if you have a discount or scholarship code
Please enter your code*
Please note that the discount/scholarship does not apply to towards the enrollment deposit but will be applied to the program tuition.
e. Credit Card Information
*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Save and Continue Later

5. Review & Submit Your Application

Please review the information below for accuracy. If you need to make any changes, simply click on the step links above to jump to that page.

Student Information

Name	{student first name:1} {student middle name:3} {student last name:2}	Preferred Name	{student preferred name:4}
Date of Birth	{date of birth:5}	Country of citizenship	{country of citizenship:18}
Sex	{sex:7} {transgender:20}	Height	{height:8}
Weight	{weight:9} lbs.	T-shirt Size	{t-shirt size:10}
Phone	{student primary phone:13} {student primary phone type:159}	Email	{student email 1:11}
Mailing Address	{student street address 1:29}, {student street address 2:30} {student cIty:31}, {student state/province:175:value} {student zip:32} {student country:34}
School Info	{school:14}
Current Grade	{grade:15}
How I heard about ActionQuest: {Learn About:52}

Parent/Guardian Information

First Parent/Guardian Information (if applicable)		Second Parent/Guardian Information (if applicable)
Relationship	{parent/guardian 1 relationship:136} {parent/guardian 1 relationship:126}	Relationship	{parent/guardian 2 relationship:137} {parent/guardian 2 relationship:145}
Name	{parent/guardian 2 first name:98} {parent/guardian 1 first name:99} {parent/guardian 1 last name:100}	Name	{parent/guardian 2 first name:113} {parent/guardian 2 first name:112} {parent/guardian 2 last name:111}
Email	{parent/guardian 1 email:114}	Email	{parent/guardian 2 email:115}
Primary Phone	{parent/guardian 1 primary phone:102} {parent/guardian 1 primary phone type:103}	Primary Phone	{parent/guardian 2 primary phone:110} {parent/guardian 2 primary phone type:109}
Secondary Phone	{parent/guardian 1 secondary phone:101} {parent/guardian 1 secondary phone type:104}	Secondary Phone	{parent/guardian 2 secondary phone:108} {parent/guardian 2 secondary phone type:107}
Mailing Address	{parent/guardian 1 street 1:138}, {parent/guardian 1 street 2:139} {parent/guardian 1 city:140} {parent/guardian 1 state:173:value} {parent/guardian 1 zip:142} {parent/guardian 1 country:143}	Mailing Address	{parent/guardian 2 street 1:147}, {parent/guardian 2 street 2:148} {parent/guardian 2 city:149} {parent/guardian 2 state:174:value} {parent/guardian 2 zip:151} {parent/guardian 2 country:152}

Adventure Information

Primary	{primary trip:188}	Back-up	{back up trip:178}
Applying for two adventures?	{two trips:195} - {secondary trip:196}

Your Previous Experience

Scuba: Certified or have referral by summer?	{Scuba Certs:239} {What Scuba Certs:241}
Sailing: Do you have experience?	{Sailing Experience:240} {What Sailing Experience:242}

Medical Information

Any medical considerations?:	{health considerations:66} {What health considerations:71}
Under the care of a therapist, psychiatrist or psychologist in the last 12 months?:	{Psychiatrist:70}

Terms Agreement - Including Enrollment, Payment, Refund, Cancellation and Dismissal Agreements; Medical Authorization & Expense; Authorization to Use Images of Participant; Dispute Provisions

{student terms agree:176:value}
{parent terms agree:268:value}

Participant Agreement - Including Declaration of Activities and Risks, Acknowledgment and Assumption of Risks & Liability Release and Indemnity

{student participant agree:177:value}
{parent participant agree:270:value}

Trip Insurance

{USA & Canada Insurance:201:value}{USA & Canada Insurance:259:value}{NY State Insurance:210:value}{NY State Insurance:258:value}{Non US Insurance:213}

Payment Information

Once program availability and suitability has been verified, {Total:191} US Dollars will be charged to your {Credit Card (Card Type):192.4}, {Credit Card (Card Number):192.1}. You will receive a separate email confirming this transaction sent to the email address that you specify below.

{Saving Code Blurb for App 1:221} {Promo Code:218} {Saving Code Blurb for App 2:220}

Date of Submission*
Date Format: MM slash DD slash YYYY
Confirmation Email
This is the email address that we will send confirmation of enrollment and payment to.*
Press the Submit Button Only Once

Complete your application by pressing the submit button below. Form processing time depends on your internet speed, so please only press the button once in order to avoid multiple submissions.
Comments
This field is for validation purposes and should be left unchanged.

Save and Continue Later

	Other Programs We Offer
	Give a little and gain a lot as you explore the world helping those in need. gobeyondtravel.com
	Take your studies to the sea and earn college credits while you sail the globe. seamester.com

Enrollment Application

1. Student Information

Student Details

Student Home Address

School Information

Your Previous Experience

Medical Information

2. Parent / Guardian Information

Please provide us with as much information as you can.

First Parent / Guardian Information

Second Parent / Guardian Information

3. Adventure Selection, Terms & Agreements

a. Adventure Selection

Your adventure selection is not valid. Please reselect a valid adventure from the list above.

Enrollment for our 40 & 50-day Eastern Seaboard Voyage is by invitation only until October 15th, 2019. If you are enrolling during this period please enter your invitation code to continue.

Your adventure selection is not valid. Please reselect a valid adventure from the list above.

Your adventure selection is not valid. Please reselect a valid adventure from the list above.

b. Terms Agreement & Participant Agreement

4. Insurance & Deposit

a. International SOS Membership & Emergency Evacuation Insurance (required)

b. Tuition & Medical Insurance (Optional)

b. Deposit Details & Payment Authorization

d. Discount / Scholarship Code

e. Credit Card Information

5. Review & Submit Your Application

Student Information

Parent/Guardian Information

Adventure Information

Your Previous Experience

Medical Information

Terms Agreement - Including Enrollment, Payment, Refund, Cancellation and Dismissal Agreements; Medical Authorization & Expense; Authorization to Use Images of Participant; Dispute Provisions

Participant Agreement - Including Declaration of Activities and Risks, Acknowledgment and Assumption of Risks & Liability Release and Indemnity

Trip Insurance

Payment Information

Confirmation Email

Press the Submit Button Only Once