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Primary Trip Choice Primary Session Choice Secondary Session Choice (Optional)

Secondary Trip Choice (Optional) Primary Session Choice Secondary Session Choice (Optional)

Participant Info

Have you previously been on a Broadreach trip, or completed an enrollment application? Yes No

First Name Last Name Preferred Name DOB Gender Email Best Phone Current Grade T-Shirt Size

I think we found you! Please update any info that has changed and confirm if we have identified you properly.

We have the rest of your info from a previous Broadreach trip.

How did you first hear about Broadreach? Is there a history of asthma, diabetes, seizures, severe allergic reactions or any other medical condition that may affect or preclude participation in this program? Yes No Please provide details about these medical conditions SCUBA level

Parent Or Guardian Info

Can you provide contact information for a parent or guardian? Yes No

We have this info from a previous Broadreach trip.

Relation to student First Name Last Name Country Mailing Address Mailing Address 2 City State State/Province Postal/Zip Code Email Best Phone Alternate Phone

Tuition Protection, Tuition Payment, Terms & Agreement

Broadreach recommends purchasing a travel and tuition protection plan (including 'Cancel for Any Reason' if available). In addition to coverage for emergency medical expenses and evacuation, as well as lost or delayed baggage, this plan helps protect your investment in case your trip is cancelled, interrupted or delayed for unexpected covered reasons. Click here to learn more and compare tuition protection options.

Add Tuition Protection Checking here constitutes my electronic signature. I confirm that I have read, understand and agree to the policy terms and conditions, and important notices and disclosures, which includes fraud warnings, privacy notice, and consent to electronic signature and delivery. I confirm that I am at least 18 years age. If this policy is purchased for a person under the age of 18, I hereby confirm that I am his/her parent or legal guardian.

Trip Tuition

Trip Deposit

A $1000 deposit, plus tuition protection insurance if chosen, is required-field to hold a spot on a Broadreach trip. If you elect to mail or wire payment, please note that we cannot hold or guarantee a space until we receive the deposit.

Tuition Payment

To reserve your spot on a Broadreach program, we require a 50% tuition payment to officially reserve your spot. The remainder will be due in 30 days. This allows us to start planning on your behalf right away. We're so excited that you'll be traveling with us!

Tuition Payment

Since we're so close to the start of summer, we require tuition payment in full to officially reserve your spot. This allows us to start planning on your behalf right away. We're so excited that you'll be traveling with us!

Select payment method

Name On Card Credit Card Number Expiration / CVC Name On Account Account Type Routing Number Account Number Amount

Communication and full disclosure are important to us; please read and accept the following terms of agreement before submitting your application.

Terms Of Agreement

Broadreach Adventures, LLC (“Broadreach”) operates international adventure programs (“Program/s) for middle school, high school, and college students, and adults. Please read this document completely and carefully.

This Terms of Agreement and Participation (“Agreement”) sets forth the terms of the Participants enrollment in a Broadreach Program. This Agreement must be signed by all Participants, and a Parent or legal guardian if the Participant is a minor. “Participant” includes adult and minor Participants, unless indicated otherwise. “Parent” includes a parent or legal guardian of a minor Participant. In consideration of the services provided in the Program, I agree, for myself (and for the minor Participant if I am signing as a Parent), to the following:

Enrollment and Admissions Policies
Enrollment requests are processed on a first come basis. After submitting your request you’ll receive an automated email confirming we’ve received your enrollment request. If space is available on your first choice Program, we will charge the payment method you provided on the enrollment form and send confirmation emails, which will be followed by a phone call to go over what’s next in our enrollment process. If we cannot place you on your first choice Program, we will not charge your deposit and will follow up by phone to discuss other options. Please contact the Broadreach office immediately if the Participant has a condition that could affect their ability to participate as we will need to immediately begin our medical review process. It is imperative that medical (including mental health) information and history be accurate and current and if requested, authorized by a licensed medical practitioner. Failure to provide accurate medical information, or knowingly omitting and/or falsifying submitted medical information will result in denied acceptance and/or potential removal from a Broadreach program at additional expense. Broadreach programs vary in challenge level and we advise all Participants to consider the physical and mental demands of their Program and prepare accordingly. It is the responsibility of each family to be informed about the specific demands and requirements of their Program. We will provide you with access to required forms via your Broadreach Portal. Final acceptance and participation in the Program is contingent on Broadreach’s timely receipt and review of all required forms and tuition payments. Broadreach reserves the right to cancel applicants with no return of fees if our forms are not completed 30 days prior to departure date.

Deposit & Tuition Payments 
Through February 14 of the year of travel, a $1000 tuition down payment/deposit is required to secure a Program reservation.  The $1000 deposit is refundable through January 15, after which your deposit is non-refundable for any reason. Full tuition is due February 15 of the year of travel. For reservations made on or after February 15 of the year of travel ½ of Program tuition is due at the time of enrollment to secure a Program reservation. Tuition balance is due 30 days from the date of enrollment. For students enrolling on or after May 1st of the year of travel full tuition is due at the time of enrollment.  Any payments made with a credit card will carry a 3% processing fee with the exception of the $1,000 tuition down payment/deposit made prior to February 15. 
For enrollments prior to February 15: $1000 tuition down payment/deposit due immediately. The remainder of tuition will be charged automatically on February 15
For enrollments on or after February 15 - April 30: ½ of tuition is due immediately. The remainder of tuition will be charged automatically 30 days later
For enrollments on or after May 1: Full tuition is due immediately

Refund Policy
When you sign up for a Broadreach Program, you have accepted a limited space within a small group. Once that space is reserved, we are no longer able to offer it to others. Regardless of the reason for cancellation or if the cancellation occurs during the trip due to dismissal, medical, or another reason, Broadreach is not able to provide any tuition refund. Due to the seasonal nature of our programs and our investment in staffing, planning, food, outfitters, and equipment before a trip, we have a strict no refund policy. Expenses are contracted for the season and are based on a total group rather than a per person basis. Broadreach cannot recover Program related expenses from cancellations even due to illness or injury, late arrival, early withdrawal, or cancellation for any reason. For cancellations after January 15 but before February 15, the applicant forfeits $1,000 of the tuition down payment/deposit/applied voucher. For cancellations after February 15, applicants forfeit all tuition paid, including any applied vouchers. Broadreach requires notification of your cancellation in writing. Broadreach reserves the right to cancel a Participant for over-due and/ or non-payment of tuition. Broadreach is not able to provide any tuition refund other than what is outlined.
From January 16 - February 15: Cancellations incur a fee of $1,000
After February 15: Cancellations incur 100% of the Program payment made

Broadreach requires that all of our Participants have medical insurance that covers international travel. For all US families, we highly recommend purchasing Trip Mate’s Tuition Protection and Travel Insurance policy offered through Broadreach. If you live outside the US, you are not eligible for a Trip Mate Insurance policy but Broadreach will recommend another insurance company.

Program Alteration 
Broadreach reserves the right to cancel or alter some aspects of a Program, including Program itinerary, Program dates, Program location or duration, as a result of unforeseen circumstances, or for any other reason. Broadreach reserves the right to cancel any Program because of inadequate enrollment that makes the Program economically unfeasible to operate. In this event, Broadreach will refund your tuition paid. However, we are unable to refund any tuition following Program cancellation that results from factors including but not limited to terrorism, natural disaster, civil, military, or political unrest, inbound/outbound travel restrictions, disease (including but not limited to a pandemic such as COVID-19), changed airline access, or other major global or local events. Broadreach is not responsible for costs incurred by a participant’s family in preparing for a program that is altered or canceled. To help mitigate the risks of such a cancellation and to avoid the possibility of unexpected loss, Broadreach strongly recommends you purchase tuition protection and travel insurance.

Dismissal
It is understood that Broadreach reserves the right to unenroll or dismiss a Participant from a Program if Broadreach believes, in its sole discretion, that Participant presents a safety concern or medical risk to themselves and/or others; is disruptive; breaches (or is associated with those in breach of) any agreement with Broadreach including the Participation Agreement; fails to meet Broadreach’s enrollment requirements or conducts him or herself in a manner detrimental to Broadreach or other Participants.

Additional Costs
Tuition does not include airfare to and from the Participant’s Program. Participants and parent/s are responsible for any and all costs of early departure whether for medical reasons, dismissal, personal emergencies or otherwise. These costs include but may not be limited to: medical evacuation, medical treatment, air transportation (including cancellation, new ticket or rescheduling fees), train, taxi or bus fare, meals, accommodations, phone calls, compensation and/or expenses for Broadreach staff/instructor who may accompany (at the sole discretion of Broadreach) a Participant and costs not covered by insurance including related post-departure costs. Enrollment in multiple Broadreach Programs in the same summer will be considered a single Program in the event of withdrawal or dismissal and all paid tuition will be forfeited.

Payment Agreement
I agree that my card or checking account will be added to the Participant’s account and will be automatically charged for Program tuition or other unpaid balances unless I notify Broadreach otherwise in writing. I understand that I can change primary and secondary payment methods in the Participants portal, at any time prior to payment due date, or cancel in writing payments subject to these terms and cancellation policy. Broadreach will attempt to send payment reminders prior to payment due dates, as well as notice of charges for payments processed, but Broadreach will not be required to do so.  Credit cards used to pay tuition or balances will have a 3% fee added.

By submitting this form, I authorize Broadreach to charge my credit or debit card or draft my checking account and agree to these financial and cancellation policies outlined in this agreement, even if I did not fill out the original enrollment form. All payments are final and non refundable for any reason except for what is outlined by our "Deposits and Tuition" section and "Refund Policy" section above.

I agree to the Terms Of Agreement


Benefit	Description	Tuition Protection including Cancel for Any Reason	Tuition Protection and Cancel for Covered Reasons Only	Travel Protection
Trip Cancellation	Trip Cancellation covers up to 100% of your pre-paid, non-refundable trip cost (up to $20,000) if you need to cancel your trip for a covered reason.
Cancel for Any Reason	Cancel For Any Reason allows cancellation of a covered trip (up to $10,000) for any reason not otherwise covered by the policy, up to 75% (50% in Florida) of nonrefundable trip costs. You must purchase the plan more than 10 days before departure date, within 15 days of initial trip deposit, insure your full trip cost, and cancel before 48 hours of scheduled departure. Not available to NY residents.
Travel Medical	Travel Medical Expense can cover up to $100,000 ($50,000 for NH residents) for the costs to treat a medical emergency during a trip. Emergency Evacuation & Repatriation of Remains covers up to $500,000 for the transportation of a traveler to the nearest adequate medical facility, or home. in the event of a medical emergency during the covered trip.
Baggage	Baggage Loss coverage provides up to $2,500 for reimbursement of lost, stolen, or damaged luggage, sporting equipment and personal effects. Baggage Delay reimburses up to $100 per day or $500 per trip to cover the purchase of clothing, toiletries, and other essential items if your luggage is delayed for a specified period of time.
Trip Delay	Trip Delay provides up to $200 per day and $2,500 per trip to cover the costs of meals, local transportation and accommodations when your trip is unexpectedly delayed for covered reasons.
Trip Interruption	Trip Interruption coverage reimburses up to 150% of your pre-paid and non-refundable trip cost if a portion of a trip is missed, or if you must return home early due to unforeseen circumstances, including illness, injury, or death.
Accidental Death & Dismemberment	Accidental Death & Dismemberment provides $100,000 of coverage ($50,000 in NH) in the event of loss of eyesight or hearing, loss of limbs and death resulting from an accident while traveling. (not available in California)
Important Note: battleface Travel Insurance plans are underwritten by Spinnaker Insurance Company (an IL Corporation, NAIC# 24376), with administrative office at One Pluckemin Way, Suite 102, Bedminster, NJ 07921. Plans are offered and administered by battleface Insurance Services LLC, 45 East Lincoln Street, Columbus, OH 43215, National Producer Number 18731960 (FL License number L107363/CA License number 0M75381). Travel Retailers offering this plan may not be licensed insurance producers and cannot answer technical questions about the terms, benefits, exclusions, and conditions of this insurance or evaluate the adequacy of your existing insurance. Your Travel Retailer may be compensated for the purchase of a Plan and may provide general information about the Plans offered, including a description of the coverage and price. The purchase of this Plan is not required in order to purchase other travel products or services offered by your Travel Retailer. This is a brief description of the coverage provided under policy series RIG-1000. The Policy will contain reductions, limitations, exclusions, and termination provisions. Please refer to the Policy for complete details. If there are conflicts between the information on this site and the Policy, the Policy will govern in all cases. Not all products or coverages may be available in all jurisdictions. Non-insurance assistance services are provided by Robin Assist LLC (in CA: battleface Insurance Services dba Robin Assist).

Broadreach Enrollment Application

Choose Your Program

Participant Info

Parent Or Guardian Info

Tuition Protection, Tuition Payment, Terms & Agreement