Rustic Pathways
2008
Early Bird
APPLICATION FORM


SIGN UP IN NOVEMBER – TAKE 5% OFF THE PRICE OF THE PROGRAM or PROGRAMS YOU JOIN

$50 application Fee! (Compared to $100)
EXTENDED PAYMENT PLAN - Spread your trip payments over 7-10 months depending on when you apply and when your trip departs.
NO INTEREST - If you choose to pay in monthly installments there is no extra cost.
Guaranteed LOWEST Price! --- If our published catalog price is higher than the Early Bird Price, you get the lowest price.
Cancel before March1, 2008 --- All your payments will be refunded without penalty.
f
Add an additional program before February 1, 2008 --- Without administration charges.

We do not allow program changes for our Early Bird students.  Instead, you are able to cancel without penalty and sign-up for a new program.  Please note that your discount is determined by when you apply.

For example:  If you sign up for our Turtle Conservation Project in November, you'll receive a 5% discount.  If in December, you change your mind and decide you'd rather join the Surf the Summer program, we'll cancel your Turtle week (with no penalty) and you wouldn't receive an Early Bird discount on your week of Surf the Summer (you would have to pay the full price of the program).

ALL APPLICATIONS ARE SUBJECT TO AVAILABILITY – SIGN UP TODAY!

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Fields marked with an asterisk * are required.
TELL US ABOUT YOURSELF

 Full Name as it appears on passport.
 First Name *  Middle Name  Last Name *
 Nickname  Sex *
 M  F
Have you ever traveled with Rustic Pathways before? *
 Yes  No
 Home Address *
 City *  State *  Zip Code *  Country *
 Home E-mail *  How often do you check your E-mail? *
 Phone Numbers *
 Home Phone  Room Phone (only if you live at school)  
  Age  
Home Fax      
 Birth Date (MM/DD/YYYY) *  Height / Inches *  Weight / Pounds *
/ /
 Current School
( For Students Only, If Parent Please Write n/a )  *
 Grade This Year
( For Students Only, If Parent Please Write n/a ) *
 Do you have any allergies, disabilities or special health considerations that we should know about? *
Yes No



TELL US ABOUT YOUR FAMILY

 Mother's Name  First  Last
Mrs. Ms. Dr.
 Mother's Home Address (only if different from home address)
 City  State  Zip Code Country
 Mother's E-mail Address
 Mother's Phone Numbers  Home  Work  Cell
 
Mother's Fax Number
     
 
 Father's Name  First  Last
Mr. Dr.
 Father's Home Address (only if different from home address)
 City  State  Zip Code  Country
 Father's E-mail Address
 Father's Phone Numbers  Home   Work  Cell
 
 Father's Fax Number      
     

 Do you have any other information regarding your application, and where to send your acceptance letter?
 Where would you like us to send your acceptance letter?  
Send to both parents Send to mother only Send to father only



SELECT YOUR TRIP FIRST

Click the first box below and select the country where your first program begins. Next, choose the program that you'd like to join, and finally your the first date of departure in the third box. In each subsequent section, select the second, third, fourth programs you'd like to add-on to your first trip and they'll automatically be linked together. If you make an invalid selection (i.e., the dates don't match up), we'll notify you shortly. As long as your dates and programs are available we will send you an acceptance letter both by e-mail and by priority mail to confirm your place in the program. This letter will also have further instructions on how to complete the registration process. It is important to remember that most of our trips link up seamlessly, even if it appears that they miss each other by a day or two - this is due to travel time. If you have any questions, please feel free to call us toll-free at (800) 321-4353.
Select your first trip below.
This is the first program you will join for the 2008 summer. Trips are listed in alphabetical order.
In this list you will select your TRIP and also your DEPARTURE DATE from home:
 *

 *

 *
If you are doing a second trip (add-on) after your first trip, select your 2nd trip below.
Most trips connect, and the trip selected below will immediately follow your first trip:


If you are doing a third trip (add-on) after your second trip, select your 3rd trip below.
Most trips connect, and the trip selected below will immediately follow your second trip:


If you are doing a fourth trip (add-on) after your third trip, select your 4th trip below.
Most trips connect, and the trip selected below will immediately follow your third trip:



REGARDING FLIGHT INFORMATION

For those traveling to Costa Rica, Peru or India, Rustic Pathways will ticket you from your city of choice directly to your program or programs. Students traveling to all other destinations are responsible for their own domestic airfare to connect with their group flight departure. Only those students originating from an international destination are allowed to make their own international flight arrangements. Those originating from the United States must travel to their programs with the scheduled international group flights arranged by Rustic Pathways. A complete breakdown of flight costs will be provided with your acceptance letter.

I will be traveling to Costa Rica, Peru or India with Rustic Pathways yes      no
If you answered yes , which city / airport would you like to depart from?

* Students who combine their India program with any of our exciting programs in Thailand, Vietnam, Cambodia, Burma or China will normally be routed from the USA to Delhi on escorted Singapore Airlines flights for more convenient and economical connectivity. Rustic Pathways will not be able to handle their domestic bookings.

Students Who Are Citizens of a Country Outside the United States
I am a resident of a country outside the United States and will be traveling from my home country. I will be departing from (name of airport) and will be doing my own airfare.
THE TOTAL COST OF YOUR TRIP

The total cost of your trip is simply the cost of the trip or trips that you have selected, plus the cost of the airfare for your program. You are also responsible for any tax on your plane ticket, as well as departure taxes from the country or countries you visit. Our acceptance letter will provide a careful breakdown of your total trip cost. Spending money for souvenirs, film or other purchases is your responsibility.

Included in the cost of your trip is a free Rustic Pathways T-shirt!
Rustic Pathways gives every student one FREE 2008 Summer t-shirt. We ask you to wear our cool shirts whenever you are flying with Rustic Pathways or connecting between trips. Please check your t-shirt size below (these are men’s sizes) and we will send your free shirt with your airline tickets.

In the box below, indicate the size of your free t-shirt.

 Size of free T-shirt (Check One) *
Youth L14-16 S M L XL XXL XXXL
Most students ask for 2 or 3 spare shirts to give as gifts, to use for signing nights, and to wear when their shirt gets funky. Each extra shirt is $ 15. Please order your additional shirts by indicating the number of each size below. We will send these with your airline tickets as well.
How many spare T-shirts do you want to order? Please select the number in the appropriate box!
Youth L14-16 S M L XL XXL XXXL

ABOUT THE RUSTIC PATHWAYS ORGANIZATION

Rustic Pathways (USA), Inc., (“Rustic Pathways”) is based in the State of Ohio. The company offers travel programs throughout Australia, Thailand, New Zealand, Costa Rica, The Fiji Islands, The South Pacific, Africa, India, Vietnam, New Caledonia, Burma, Cambodia, Peru, China, and the world. Rustic Pathways offers adventure, community service, language, and educational programs for high school students, college students, groups, individuals, and families.


CANCELLATIONS, ITINERARY CHANGES AND REFUNDS

Rustic Pathways reserves the right to cancel, alter, reschedule, or amend any or all programs offered at any time. If a trip is cancelled by Rustic Pathways prior to the beginning of that trip, Rustic Pathways will refund all payments made by the applicant. If a trip is cancelled by Rustic Pathways once it has begun, a portion of the applicant’s total payments will be refunded. Once your application has been accepted, cancellation by you results in a penalty. If you decide to cancel for any reason before March 1, 2008 – we refund all money you paid without any penalty or administration fee!  There’s no risk to you or your parents! Cancellation by you on or after March 1, 2008 and before May 1, 2008 results in the loss of 50% of your total trip cost. Cancellation by you on or after May 1, 2008 results in the loss of 100% of your total trip cost. We will supply information on optional trip cancellation insurance with your acceptance letter. You may also postpone your trip - just advise us in writing at least 45 days prior to your departure. We will hold your payments in escrow and these can be applied to any Rustic Pathways trip taken in the next two years.


INSURANCE

Rustic Pathways does not provide any form of insurance against any accident, injury, loss, illness, or death which could occur while a student is overseas. Parents must ensure that their son or daughter is fully covered for any medical expenses which may be incurred during their trip. Injuries do occur, and health insurance is mandatory for all participants. Rustic Pathways will supply you with information about a travel insurance policy that many of our participants select. Participants and their parents are responsible for any and all medical costs incurred before, during or after a Rustic Pathways trip regardless of the cause.


LIABILITY WAIVERS, RELEASES, MEDICAL DISCLOSURES & RULES

Both participants and their parents will be required to sign and comply with various liability waivers and releases prior to the beginning of any Rustic Pathways trip. Rustic Pathways operates various trips in diverse countries, terrain and conditions. Many Rustic Pathways trips include challenging components such as bungee jumping, sky diving, heli-skiing, paintballing, zorbing, river boarding, kayaking, boating, cycling, 4-wheel-driving, horseback riding, rafting, aircraft flight, rappelling, abseiling, mountain climbing, zip-lining, elephant riding, scuba diving, mountain biking, surfing, skiing, hiking, camping, game viewing, working with machinery and tools, snowboarding, and travel in remote areas, as well as other potentially dangerous activities. Neither Rustic Pathways nor its officers, directors, contractors, employees, agents or staff can safeguard against injuries or accidents which may occur for whatever reason on any trip. Participants will not be permitted to travel on any Rustic Pathways trip unless all required paperwork has been received in our Ohio office at least 30 days prior to the commencement of the applicant’s trip.


PASSPORTS, VISAS & IDENTIFICATION

All participants require a valid passport for our international programs. You can not travel overseas without a passport. Don’t leave it at home! Please send a black and white copy of your passport when you apply. If there are visa requirements, you will be notified.


WHAT WE EXPECT FROM PARTICIPANTS

Rustic Pathways expects participants to be enthusiastic, cooperative and appreciative of the opportunities afforded to them through our programs. The use of illegal drugs, tobacco, and the consumption of alcohol is strictly forbidden on all trips. Trips sometimes operate under difficult and challenging conditions, and Rustic Pathways expects participants to be cooperative and attentive at all times. Rustic Pathways reserves the right to remove any student from any trip at any time without any refund if a student uses drugs, alcohol or tobacco, endangers the lives of other students, or consistently disregards staff instructions. Students who use drugs, alcohol or tobacco, possess an uncooperative attitude or are unwilling to work happily within a team environment should not apply for a Rustic Pathways program.


IMPORTANT INFORMATION ABOUT TRIP PAYMENT AND TRIP CANCELLATION

A $50 application fee is charged with your Early Bird Application. The application fee received after the Early Bird promotion has expired on December 1, 2007 will be $ 100. After April 15, 2008, the application fee will be $ 200. This fee is refundable only if we are unable to accept you into the program(s) you request. The total cost of your trip is then payable in equal monthly installments. Your first monthly payment is due 15 days after your acceptance date. Remaining payments are due monthly. Complete trip payment must be received 65 days prior to your scheduled departure. During the normal application period trip payments are spread out into equal monthly installments as this makes it easier for many families to afford a summer program for their children. All trip payments must be paid either by check or cash and must be paid on or before their due date. All late payments will incur a $50 late payment charge.

Rustic Pathways reserves the right to cancel a student’s place or reservation on any program if payment is not made on time.


 Student has read, understands and agrees to abide with the above statement.*
 Parent/Guardian has read, understands and agrees to abide with the above statement.*
 
              Type of Card
 Visa
 MasterCard
American Express
 Expiration Date:(mm/yyyy)
 Full Name on  Credit Card: 
 Card Number:

I wish to submit my application now


PLEASE READ CAREFULLY AND CHECK WHERE INDICATED

We would like to apply for admission to a Rustic Pathways program. We have read the Rustic Pathways brochure and application form carefully, and we willingly agree to comply with all of the various requirements and conditions spelled out in these materials. We understand that student travel can be dangerous and we agree to abide by the rules, conditions and instructions provided by Rustic Pathways to minimize the risk of injury, accident, damage, or death. We further understand that Rustic Pathways has the right to remove any applicant from any program at any time if their behavior or participation is deemed to be detrimental or dangerous to themselves or others. We also understand that we will be required to sign and comply with various written waivers, liability releases, and terms and conditions as a condition of participation in this program. We fully understand that the relationship between us and Rustic Pathways (USA), Inc., (“Rustic Pathways”), will be governed by the laws of the State of Ohio and any suit, mediation or arbitration of any dispute with Rustic Pathways must be filed exclusively in the State of Ohio. We understand Rustic Pathways will send a confirmation letter within 5 days of their receipt of this application.

IMPORTANT: Please be sure both applicant and parent/guardian complete of this application

 Parent or Guardian agrees to these terms and  conditions *  Date(mm/dd/yyyy) *
 Applicant agrees to these terms and conditions *  Date(mm/dd/yyyy) *


 

If you have any questions, please ring us at (800) 321-4353.
Callers outside the USA may phone us at 1+ (440) 975-9691.
You can e-mail us at rustic@rusticpathways.com
or fax us at 1 + (440) 975-9694 so we can help you.
We care about you, and we want to help you select the best program for yourself or your son or daughter.