Fee Includes: All Travel Costs--flights, busses, metro, etc., Breakfasts, Lodging, Assigned Attractions. Full Name Gender: M or F (circle)

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1 BYU-Idaho 2015 European Religious History Travel Study Application Complete, sign, and submit this application (pages 1-5), along with your letter of intent, to either: Bro. Robert Wahlquist, Department of Religion, Taylor 228, Rexburg, ID Bro. Jeff Chapman, Department of Religion, Taylor 223, Rexburg, ID Bro. Todd Hammond, Department of Religion, Taylor 115, Rexburg, ID Tour Fee Approx. $4,300 Fee Includes: All Travel Costs--flights, busses, metro, etc., Breakfasts, Lodging, Assigned Attractions Fee does not include: Some meals, Passport Fees, $10 Tour Book, BYUI Tuition, Souvenirs, etc. Full Name Gender: M or F (circle) Preferred Name Name as it appears (or will appear) on your passport Country Issuing Passport Passport Number (if you have one) Age Date of birth Citizenship (U.S., Canada, etc.) Single or Married (circle) If single, is there anyone with whom you have a boyfriend/girlfriend relationship who is also applying for this study tour? YES or NO (circle) (required) Phone ( ) Served Mission: YES or N0 (circle); If YES, where Have participated in another BYUI Travel Study Program: YES or NO (circle) If Yes, which program Admitted to BYU-I: YES or NO (circle) If Yes: Supply your BYU-I ID # Your BYU-I Track BYU-Idaho address City/ZIP If No: What is your status? (check) BYU-I graduate (either with an associate or bachelor s degree) Year & semester of graduation Other: Please explain:

2 Year in College: FRESHMAN SOPHOMORE JUNIOR SENIOR (circle) 2 Number of Credit Hours Completed To-date ; Overall GPA If you are an BYU=I Freshman, what was your final High School GPA? Parent/Guardian Name Phone ( ) Address City/State/ZIP In case of emergency, notify (if different from parent/guardian): Name Relationship Phone ( ) Address City/State/ZIP STUDENT COMMITMENT: If accepted as a member of this program, I promise to: 1. Support and uphold the moral standards and ideals of the LDS Church. 2. Follow the behavior, dress, and grooming codes of BYU-Idaho. 3. Abide by the decisions of the tour directors in all matters pertaining to the tour. 4. Accept the will of the majority whenever a matter of choice presents itself. 5. Always be in a group of 3 or more while in Europe. 6. Make payments by the deadlines outlined I understand I may be sent home at my own cost if I fail to adhere to these regulations. Signature of Applicant Date: Signature of Parent/Guardian Date: (Participants under 21 or financially dependent upon parents/guardians must have parental/guardian approval.) References: College Bishop: Name Tel ( ) Home Bishop: Name Tel ( ) Professor: Name Tel ( )

3 3 Assumption of Risk and Release Agreement: I know and recognize that participation in a Travel-Studies program conducted by BYU-Idaho is done on a voluntary basis without compulsion or coercion and is not a mandatory class requirement. I know there may be dangers and hazards associated with the tour and assume the risks associated with participation in the tour, including but not limited to: the hazards associated with travel, whether by land, sea, or air including airplane, auto, or bus crashes; being struck by a vehicle or suffering physical exertion; hazards of unstable governments and related potential violence; hate crimes; illness caused by food, water, heat, cold, altitude, or contagious disease; assault, theft, or robbery; trip cancellation or change in itinerary and travel plans; acts of God; any activity I decide to participate in during free time. I acknowledge that these hazards could cause physical or emotional harm or even death. Knowing the risks, and in consideration for being permitted to participate, and as inducement to BYU Idaho to permit me to participate in this tour, I hereby, for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue and waive, release, and discharge BYU-Idaho, its agents, officers, and employees from any and all claims or liability for death, personal injury or property damage of any kind or nature, and any other claims whatsoever arising out of or in any way connected with my participation in this tour, even though liability may arise out of carelessness on the part of BYU-Idaho, including its officers and employees. This release extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. I have carefully read the general information and any additional written information concerning the program as furnished by the university. I hereby represent that I am qualified in all respects to apply for a BYU-Idaho travel study program and agree to all of the terms herein. I authorize the disclosure of my personal record file at the university, including transcripts and financial information, for the purpose of evaluating my eligibility for acceptance into the program. If for any reason my status at BYU-I changes prior to departure on the program, I will notify the travel study programs office. MY SIGNATURE BELOW AFFIRMS THAT I HAVE CAREFULLY READ THIS ASSUMPTION OF RISK AND RELEASE AGREEMENT AND THE OTHER TERMS; I UNDERSTAND ITS CONTENT AND PURPOSES, AND I VOLUNTARILY AGREE TO ALL THE TERMS SET FORTH ABOVE (signing constitutes an binding legal agreement). Participant signature Date: Parent/guardian signature: Date: (Required if participant is under 21 or dependent on parent/guardian)

4 Student Health Form and Medical History 4 Legal Name: (First) (Middle) (Last) Participants must consider their stamina and health conditions in deciding if they can meet the physical and emotional requirements of an almost four-week rigorous (walking several miles each day) travel schedule. Participants should be in a sufficient state of health to participate fully. We advise participants to have a physical check-up before registering for the program. Brigham Young University cannot be responsible for any illness that would occur on the tour. Persons with heart disease, high blood pressure, or other physical impairments that could hinder them from normal participation with the group should contact the tour director before submitting an application. Persons who have surgery too close to the tour dates to recover fully (in the judgment of the physician and tour director) will need to withdraw so as not to jeopardize their healing process and impede the mobility of the tour group. Personal Medical History Your Health Problems Y N Your Health Problems Allergies Joint/Muscle Problems Y N Your Health Problems High Blood Pressure Asthma Back Problems Eating Disorder Colitis Heart Problems ADD/ADHD Diabetes/Hypoglycemia Stomach Trouble/Ulcers Schizophrenia Hernia Thyroid Problem Claustrophobia Hives or Rashes Seizures Dementia Reactions to Drugs Suicidal Thoughts Acrophobia Heat Reactions Depression Obsessive- Compulsive Hearing Loss Currently receiving counseling Other: (Please list) Yes: Anxiety/Panic Attacks No: PTSD Y N If yes to any of the above questions, please explain:

5 5 Are you currently taking medication? If yes, please indicate what medication and if you will be taking it on the tour. Insurance Brigham Young University Idaho has no funds to compensate for the loss, damage, or theft of luggage and/or personal belongings. With your tour fees, BYU-Idaho will purchase some emergency medical coverage due to illness or accident. This insurance will cover some or all of hospitalization and related medical expenses. Each tour participant may consider purchasing additional health or travel insurance. Health Insurance company Policy No. Policyholder's name Group No. Consent to Treatment I understand and agree that BYU-I will not have medical personnel available at the location of the program. I further agree that BYU-I personnel and students are granted permission to provide and authorize emergency medical treatment, if necessary, and that such actions are subject to the Assumption of Risk and Liability Agreement which I have signed and that they shall assume no responsibility for any injury or damage which might arise out of or in connection with such emergency medical treatment. In the event of my injury or illness, I also authorize BYU-I to select a physician(s) to administer surgical treatment or carry out such procedures as may be deemed necessary or advisable to diagnose and treat me during the course of my participation in the Religious History Tour program. I freely give this medical information to my directors, knowing that they will keep it in the strictest confidence. Participant signature Date: Parent/guardian signature Date: Date: (Required if participant is under 21 or dependent on parent/guardian) Letter of Intent Write a 1 page letter of intent explaining why you should be considered for admission in the European Religious History travel-study program. Please attach a typed letter of intent to this application. Application does not automatically guarantee admission to the program. Only about 43 students can be accommodated in each program. Admission is granted according to the relevance of the tour to students' academic objectives, program diversity, academic standing, and other program needs.

6 CLASS INFORMATION AND ELIGIBILITY: The trip is during the first block of Fall Semester Tour classes run from Wednesday, September 9th to Friday, September 18th, FLIGHTS are subject to change: We leave from the Salt Lake Airport on Sunday, September 20th. We get home to Salt Lake City on October 15 th. 6 Whether or not you are on track for the Fall 2013 semester, you will need to pay for the tuition of the tour credits you take this is not covered in the tour fees. Student may take from 3 to 10 credits during the first block. For those on track for the Fall 2013 semester, you will need to register for additional credits in the second block to maintain full-time student status. All students will need to be on campus for the 8 days of tour classes that begin on September 9th, You will have to arrange your own housing. Make plans to be in class every day. We will not excuse you unless you have an emergency. Plan for doctor and dentist's visit well in advance so that you do not need to miss class. Each day of class is valuable in preparation and a part of your tour grade. APPLICATION GUIDELINES: The tour will be limited to 43 students. PRIOR TO BEING ACCEPTED ON THE TOUR YOU WILL NEED TO BE INTERVIEWED BY ONE OF THE TOUR DIRECTORS. Bring this application with you to the interview. If accepted to go on the tour, the next step will be to make your initial deposit of $1,000 at the Cashiers Office at Brigham Young University Idaho. Designate the funds for the European Religious History Tour. Once interviewed and accepted, your initial deposit officially enrolls you on the tour. ***FAILURE TO MAKE ANY OF THE PAYMENTS AUTOMATICALLY TAKES AWAY YOUR GUARANTEED SPOT, AND PUTS YOU ON THE WAITING LIST*** Here is the tour payment schedule for the total tour cost of $4,300.00: 1. $1,000 January 15 th, 2015 Initial deposit at the time of acceptance. 2. $1,000 March 16 th, $1,000 May 15 th, $1,300 July 15th, 2013 The deposit fee ($1,000) will not be refunded for cancellation after May 16th, 2015, because at this point hotels and airline tickets will have been paid for. Applicants who cancel after this date may also be charged for any additional costs incurred for reservations that have been made. However, every effort will be made to keep losses at a minimum for an applicant who cancels. CLASS PROCEDURES: We have found that the more you know about European history, art, architecture, and religion the more enjoyment you have on this trip. So, we have designed an exciting preparation

7 7 package that will give you up to 10 university credits and prepare you for the things that you are going to see. LDS STANDARDS: All tour participants are required to live by the behavior, dress, and grooming standards of Brigham Young University Idaho. This includes abstinence from coffee, tea, alcohol, and illegal drugs. Participants must also be willing to follow the directions of the tour directors and cooperate as a group. Violation of these standards or directions could result in a student being sent home at his or her own cost. HEALTH: Participants should be healthy enough to be able to fully participate in a vigorous travel schedule. Brigham Young University cannot be responsible for any illness that would occur on the tour. Persons with heart disease, high blood pressure, or other physical impairments that could hinder them from normal participation with the group should discuss the issue with one of the tour directors during interview process. CHANGES: Brigham Young University Idaho Travel-Study Programs reserve the right to make changes or substitutions in this offer as a result of increases in fares, hotels, currency rates, or other unforeseen circumstances prior to departure. We reserve the right to cancel the tour if deemed necessary for circumstances beyond our control such as strikes, walkouts, riots, wars, acts of God, etc. In such case, Brigham Young University Travel Study Programs or its agents have no responsibility beyond refunding all deposits and moneys paid. Such refunds will be made within 30 days.

Experience Europe 2016 College of Business and Communication Application - Due February 5,2016

Experience Europe 2016 College of Business and Communication Application - Due February 5,2016 - Due February 5,2016 Complete, sign, and submit this application along with your letter of intent to BYU-Idaho, College of Business and Communication, Smith 229, Rexburg, ID 83460-0810 Fax (208) 496-5414