Gift of Time Together Application

If you are interested in participating in the Gift of Time Together™ program through the Carson Higgins Memorial Foundation, please complete the application below.

Which best describes you? (Select all that apply) *
What type of activity would you want to do with your family? (Select all that apply) *
Do you have a season that you would prefer to travel? (Select all that apply) *
How far would you be willing to travel from your home to a destination? (Select all that apply) *
What would the ideal timeframe for a trip away with your family? (Select all that apply) *

I understand and agree that my consent to these services is given in consideration of my being permitted to participate in the complementary services provided by the Carson Higgins Memorial Foundation. I acknowledge that I am a voluntary participant in these activities and assume full and complete responsibility for any injury, loss, or damage which may occur during my participation in these events hosted by the Carson Higgins Memorial Foundation. I hereby release and hold harmless the Carson Higgins Memorial Foundation, the 501©3 organization, and all employees, agents, and directors of the Carson Higgins Memorial Foundation for any and all claims, causes of action, suits, or other proceedings which in any way relate to my participation in the complementary services being offered by the Carson Higgins Memorial Foundation for personal injuries or any other damages sustained.