• North Broward Preparatory School

    7600 Lyons Road . Coconut Creek, FL . 954.247.0011

  • Global Campus Worldwide Tanzania Expedition

    Trip Dates: February 9 - 18, 2016

    Trip Cost: Approx.  $2000 per Student

    Final cost determined at time of airline booking plus an additional $325 for insurance and meals on travel days

    Registration Deadline: Monday, October 12, 2015


     

  • Student Information
    Please provide information exactly as it appears on student's passport
     
  • Parent/Guardian Information
     
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  • Trip Enrollment Agreement
     
  • Payment/Authorization/Release Agreement   I, parent/legal guardian of the above-named student (hereinafter “Student”), enter into this Agreement knowingly and willingly and hereby give my express permission and consent for the Student to participate in this program. I hereby release and hold Meritas, LLC and its affiliated companies and schools and their respective officers, employees, agents and representatives (hereinafter collectively referred as “Meritas”) harmless from any injury, loss, or damage to or by the Student. I agree to indemnify Meritas for all injury, loss or damage to the person or property of others caused by the Student. I release and hold Meritas harmless from any liability for reasonable decisions or actions as may be taken to protect the health and safety of the Student. In the event of an accident or emergency, I authorize Meritas to provide, or seek the provision of, health care services for the Student, at my expense, as deemed necessary, and I release and hold Meritas harmless from any and all liability resulting from such health care services. I further agree to assume full responsibility for the payment of all debts that may be incurred by the Student during his/her participation in this program.  
  • Student Travel Insurance 
     
    In the last several years, we have found that the demand for travel insurance for student trips has decreased. Due to this decrease in participation, we can no longer offer cost effective group travel insurance for our student trips. For those still interested in trip insurance, we would recommend purchasing an individual travel insurance policy for their student"s trip.   Travel Guard and Travel Insured both offer individual Travel Insurance plans. Both companies are highly reputable companies in the industry. Families, however, are free to purchase a plan from anyone they choose. When purchasing a travel insurance policy, it is important that you understand it"s coverage completely. Most basic policies cover only medical, injury or death related cancellations and require documentation of the same. Cancellations due to financial, disciplinary, or scheduling conflicts are not usually covered. Families should also keep in mind that they are entering into the contract alone and that Meritas and its affiliated schools are without influence or control of the purchase plan or the outcome of any claims. It is further suggested that when purchasing insurance, that you keep track of the dates and amounts of all payments for the trip and be prepared to provide documentation of same. This information will be provided should you need to submit a claim.   Here are links for two companies that we have used in the past.   Travel Guard and Travel Insured  
     
  • Consent to Treat 
     
    On this date, the above parent or guardian gives consent to Meritas LLC, all Meritas affiliated schools, and its medical representative to obtain medical care from any licensed physician, hospital, or clinic for the listed participant, for any injury or illness that could arise from participation in Meritas travel events.
     
  • Emergency Contact 1
     
  •  Emergency Contact 2
     
  •  Physician and Medical Information
     

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  • ***If your child takes daily medicine, click here to download and print an additional medical form to be submitted to Sandee Topal, RN along with the medication one week prior to the departure of the trip.**
     
  • Authorization for Over-the-Counter Medication 
     

  • NOTE:  Other than those mentioned above, All medications need to be in the original packaging, with specific instructions for administration. Please make sure your child's name is on each medication sent in. All medications must be supplied by parents and given directly to the designated chaperone/health care manager. In the event it is necessary to purchase specific medication while on the trip, your school account will be billed for the cost.
     
  • Notes  
  • By submitting this form and signing below I agree that all information contained herein is true and agree to all the terms of this Agreement.
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