Veteran Application

Hudson Valley Honor Flight Veteran Application


Hudson Valley Honor Flight honors American veterans for your sacrifices and achievements by taking you to Washington, D.C. to see YOUR memorial at no cost. At this time, priority is given to WWII veterans and terminally ill veterans from all wars. For Honor Flight Network to achieve this goal, guardians fly with veterans on every flight providing assistance and helping veterans have a safe, memorable and rewarding experience. For what you and your comrades have given to us, please consider this a small token of appreciation on behalf of Hudson Valley Honor Flight.

Required fields are marked *

  • WWII VET (12/7/41 – 12/31/46)KOREAN VET (6/25/50 – 1/31/55)VIETNAM VET (2/28/61 – 5/7/75)
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    (Please List Your First, Middle & Last Name as it appears on your driver’s license or government ID.)
  • MaleFemale
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  • T-Shirt Size: (S, M, L, XL, XXL, XXXL): *
  • How did you hear about Hudson Valley Honor Flight?*
  • Branch of Service:**
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  • (This person must be available in the local area the day you travel):
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  • Do you have a Guardian who will be accompanying you on the flight?  YesNo
  • If Yes?

    This person must submit a Guardian Application.
  • Who will be providing your transportation to and from the rally point?
    Veterans MAY NOT drive themselves on Flight Day.

  • Information provided will not disqualify you. It permits us to assess the support we need during the trip. Information is for Honor Flight & Medical Personnel only.

  • 1-Do you use mobility equipment?  YesNo
  • If YES, please indicate device: CANEWALKERWHEELCHAIR
  • Also, If YES, will you bringing your own equipment?  YesNo
  • 2- Do you take medication? What kind? How often?
  • 3- Do you have any drug allergies?  YesNo
  • Please describe what type (i.e. grand mal, petit mal, other)
  • 4- Do you have a history of seizure?
  • If within past 5 years, STRONGLY advised you discuss trip with your private physician!
  • 5- Do you have problems with motion sickness (sea or air)?  YesNo
  • If yes, is it controlled with medications?  YesNo
  • If motion sickness is not controlled with medications, it is STRONGLY advised you discuss the trip with your private physician!
  • 6- Do you have any breathing problems?  YesNo
  • If YES, please describe:
  • 7- Do you use a home nebulizer machine?   YesNo
  • If YES, you are STRONGLY encouraged to discuss the trip with your private physician concerning the use of portable hand-held nebulizers during the trip.
  • 8- Do you use oxygen at any time?  YesNo
  • If YES, you will need your private physician to write a prescription for oxygen to be used during the flight and during the tour. The prescription should be turned in with the application.
  • 9- Do you have a problem walking the length of a football field without assistance?  YesNo
  • If yes, please describe the reason (e.g. lung problems, arthritis, heart problems, etc.):
  • 10- Do you have a history of open head injuries, sinus problems, or ear problems?  YesNo
  • If YES, have you flown since the open head injury, sinus or ear problems occurred?
  • If YES, did you have any problems?
  • If YES, it is STRONGLY advised you discuss the trip with your private physician. If you have NEVER
    flown since the open head injury, sinus or ear problems, again we STRONGLY advise you discuss the trip with your private physician.
  • 11- Do you have a urostomy or colostomy bag?  YesNo
  • If YES, please make sure the bag is vented prior to flight. If you do not know if your bag is vented, it is STRONGLY advised that you discuss this issue with your private physician.
  • Additional Comments or Concerns:

The undersigned acknowledges and agrees that:

1. As photographic and video equipment are frequently used to memorialize and document Honor Flight trips and events, his/her image may appear in a public forum, such as the media or a website, to acknowledge, promote or advance the work of the Honor Flight program. I hereby release the photographer and Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during Honor Flight activities through video, photo, or other media, to be used solely for the purposes of Honor Flight promotional material and publications, and waive any rights or compensation or ownership thereto.

2. I further state that medical insurance is the responsibility of the veteran and I understand that neither Honor Flight nor the provider of free private aircraft ("Flight Provider") provides medical care. I understand that I accept all risks associated with travel and other Honor Flight Network activities and will not hold Honor Flight, the Flight Provider, or any person appearing or quoted in any advertisement or public service announcement for or on behalf of Honor Flight responsible for any injuries incurred by me while participating in the Honor Flight program.

I agree to the above statements and wish to submit this information to Hudson Valley Honor Flight.

For further information,
please contact us at 845-391-0076.