Online Veteran Application

Please use this form to complete your Veteran Application to Honor Flight Southern Nevada.

PLEASE BE AWARE: The Transportation Security Administration is reminding travelers that beginning October 1, 2020, every traveler must present a REAL ID-compliant driver’s license, or another acceptable form of identification, to fly within the United States

Online Veterans Application

Please complete the following application to experience your Tour of Honor with Honor Flight Southern Nevada.

Once the application is submitted to Honor Flight Southern Nevada, we will review the application for completeness and be in touch.

Veteran Information
Provide your Full Name as shown on Driver's License or Government issued ID
You will be provide a Honor Flight Southern Nevada T-shirt to wear on the trip.
Veteran Service History
Which Military Branch did you serve? Check all that apply.
Please provide month/year for start and finish of your military career.
Check all that apply
(if known)
Please provide your primary duty/duties while you served:
Please share any awards, certificates, commendations, conflicts, experiences or ribbons that are particularly meaningful to you:
If yes, Sorry you may only go on any Honor Flight once.
Emergency Contact Information
Please provide who HFSN may contact in the event of an emergency.
Emergency Contact Information - Secondary Contact
Please provide who HFSN may contact in the event of an emergency.
Guardian Information
If you chose No, HFSN will assign a guardian to you for your trip.
The guardian application must be completed, and guardian is aware they pay for their trip costs of $900.
If yes, your private physician must write a prescription for oxygen to be used during the flight and/or day. HFSN can only supply oxygen concentrators at the hotel. You must supply the oxygen machine needed for the flight.
If you selected "yes", please provide type of breathing problem.
If you selected "yes", please provide type of seizure
If suffered seizure within the last five (5) years, please discuss the trip with your primary physician.
If no, we strongly advise you consult your primary physician.

The only health issue that would prevent your participation is Dementia or Alzheimer’s Disease.

Please document your medical history or conditions that would impact your travel.
If yes, please make sure the bag is vented prior to the flight. If you are not sure if the bag has a vent, we strongly advise you consult your primary physician.
If yes, we strongly advise you discuss this trip with your primary physician.

In the box below, list ALL medicine, including dosage and frequency taken. Information provided WILL NOT disqualify you, however, we must ensure you are able to endure the travel.

If you take prescription medication, you are required to complete this table.  If you do not provide your medication information, your application may be not be accepted.

Have your Physician provide a Medical History and list of your current prescriptions for you to take on the trip.  It is strongly advised that you consult your private physician before making this trip.

If you have your medication information on a list, please take a photo and upload the photo.
Medical Release
    The information I have provided is complete and accurate. I understand that Honor Flight Southern Nevada medical volunteers will review my health history and may speak with my healthcare provider(s) to clarify any medical concerns. Honor Flight Southern Nevada must medically approve all participants to fly. I agree to notify Honor Flight Southern Nevada immediately should my medical condition change prior to the trip. If any of this information is falsified or pertinent medical information is omitted, or if my medical conditions change or are determined by Honor Flight Southern Nevada to be unacceptable to participate, I understand I may be disqualified from participating in an Honor Flight at the sole discretion of Honor Flight Southern Nevada. I understand that medical insurance and medical costs that may be incurred pursuant to participation are my responsibility and that Honor Flight Southern Nevada does not provide medical care. I understand that I accept all risks associated with travel and other Honor Flight Southern Nevada activities, and that I will sign a Release, Covenant Not to Sue and Indemnity agreement in favor of Honor Flight Southern Nevada while participating in the program. I hereby give consent and permission to any of my medical providers or emergency medical providers to discuss and release my health and treatment information for treatment purposes I may require during my participation in the Honor Flight Southern Nevada program and my signature on this page shall be sufficient evidence of my consent. My signature authorizes you to call my physician or any other personnel familiar with my care to discuss my medical history. Please note that a facsimile signature will also be accepted as an original signature.
PLEASE REVIEW CAREFULLY:
The undersigned acknowledges and agrees that: 1. As photographic and video equipment are frequently used to memorialize and document Honor Flight Southern Nevada (HFSN) and the Honor Flight Network (HFN) 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 HFSN and the HFN program. I hereby release the photographer and HFSN and the HFN from all claims and liability relating to said photographs. I hereby give permission for my images captured during HFSN and the HFN activities through video, photo, or other media, to be used solely for the purposes of HFSN and the HFN promotional material and publications, and waive any rights of compensation or ownership thereto. 2. I further state that medical insurance is the responsibility of the veteran and I understand that HFSN and the HFN does NOT provide medical insurance. I understand that I accept all risks associated with travel and other HFSN and the HFN activities and will not hold HFSN and the HFN responsible for any injuries incurred by me while participating in the HFSN and the HFN program. By submitting this application electronically, you are signing that you have read and agree with the above statements.
Please sign with your mouse on the line above
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