Magical Memories for Special Kids
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Agency and Group Escort Application Form

Dear Agency Escort and Dreams Take Flight Volunteers:

We are so excited to be having you join us on the flight to Disneyland on Tuesday, October 16th, 2018 as an adult escort.  Thank you for helping Dreams Take Flight Vancouver make Magic Memories for Special Kids!

Please note that all adults must have a valid Canadian or American passport and be able to legally enter the United States and to participate on the flight.   You will need a copy of your passport in order to complete this application and will need to bring the actual passport to the flight.

After you have completed the form, please ensure that you hit the "Submit" button.  If your form has been been submitted successfully, you will receive a confirmation note.  

You are applying as a(n): *
Name of Agency: (If not from an agency, please put "Dreams") *
Name : *
E-mail: *
Cell or primary phone: *
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Address: *
BC MSP Medical Services Plan Number: *
Passport For Which (Issuing) Country: *
Passport Number: *
Passport Expiry Date: *
 /  / 
Upload a copy of your passport here. (.jpeg, .doc, .xls., and .pdf are accepted.) *

Shoe Size: *
T-shirt Size: *
Please list all medications you are currently taking, including their dosage and times taken:
Do you have any medical conditions the Dreams Take Flight doctors need to be aware of and/or that may affect you on the flight?: *
If yes, please explain:
Special Dietary Requirements (eg: Diabetic meal, Vegetarian meal) or any food allergies:
Name of Emergency Contact: *
Relationship to You: *
Emergency Contact E-mail: *
Emergency Contact Cell or Primary Phone Number: *
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I am a Canadian or a US citizen and I am legally able to enter the United States of America. *
I confirm that my background and character are appropriate for involvement with children and the Dreams Take Flight programme. *
I agree to take responsibility for the care of the children I am escorting and am capable of attending to the children's needs during the entire trip. I also agree to accompany the children on rides in Disneyland and to assist the other leaders/escorts in my group with the activities of the day. *
I am physically able to handle a long and extremely tiring day of approximately 20 hours. As an escort's job is to attend to the children of his/her group's needs, I will not sleep at any time, including during the bus rides and on the flight. I will remain with my group at all times and will not leave the park alone or with a child at any time. *
I acknowledge this is a non-smoking and alcohol-free day and will therefore not consume any tobacco, alcohol, or any other controlled substance while with or in front of the children. Swearing and the use of cell phones are not permitted during the day as well. *
Adult escorts are NOT allowed to purchase anything or bring back anything from the trip due to our special customs arrangements. I will therefore not bring anything back from the trip into Canada. *

RCMP / Police Background Checks:

ALL Dreams Take Flight Volunteers will be required to do a PIC - Vulnerable Sector RCMP / police background check every two years. If you've completed this check in the past two years, please upload a copy of the report. Please Note: If you've had this check done with another organization, we may require another check be done specifically for our charity. Checks done via an online programme are not accepted.

Upload copy of Police Information Check - Vulnerable Sector if already done here.