Participant Information Form – Colebrookdale Railroad Project

Complete the fields below so we have all the information we need to make your trip comfortable and safe. This form is not savable, so you’ll need to complete it in one session. We’re looking forward to having you with us at the Colebrookdale Railroad Project soon.

    Participant Information

    Trip Dates

    Full Name

    Nationality

    Gender
    FemaleMale

    Date of Birth (mm/dd/yyyy)

    Email

    Address (including city, state, and postal code)

    Mobile Phone

    Will you be carrying your mobile phone on this trip?
    YesNo

    Other Phone (if relevant)

    Do you intend to share a room with a travel companion? noyes
    If yes, what is the name of your travel companion?
    If yes, how many beds would you like? (We will do our best to accommodate your request, but we cannot guarantee it.) onetwo

    Do you have any specific dietary needs?                                                                                                              
    Do you have any health conditions/taking medication (allergies, seizures, disease, injuries, etc)?
                                                                                                                                         

    Preferred t-shirt size?                                            

    Profession/major                                                                                                                                                           
    Does your company/institution operate a matching donations program?
    YesNo

    Interests/hobbies    

    Check what best suits you & your interests
    Photography skillsVideography skillsCarpentry skillsMasonry skillsLittle or no experience with hand toolsComfortable with heightsArchitectStructural engineerPreservationist/ConservatorInterest in historic railroadsInterest in local life and cultureInterest in historyInterest in architectureInterest in archaeology

    Emergency Contact

    Name

    Relationship to You

    Phone Numbers

    Emails

    Travel Details

    Contact us if you'd like recommendations for a travel agent or lodging before or after your trip. Leave fields blank if you do not yet have the information.

    Arrival date, time, flight numbers (include flights only if relevant; list info for all flights between departure city and arrival city)
                                                                                                                         
    Departure date, time, flight number (include flights only if relevant; list info for all flights between departure city and arrival city)
                                                                                                                   
    Accommodation prior/after trip (name of hotel, email, phone number, website)
      
                                             
    Health Insurance Provider and Policy No (must include emergency services coverage - refer to your Volunteer Information Pack)                                                                                                      

    Upload Required Documents

    1. Scan of a signed Release of Liability, Waiver of Claims and Indemnity Agreement (DOWNLOAD FORM)

    2. If under 18, scan of signed Parental Travel Consent (DOWNLOAD FORM) (even if traveling with the parent)

    Additional Information Needed

    If you have left any travel details blank above, please submit as soon as possible by email.