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Suwandi Foundation Trip Enrollment
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Suwandi Foundation Trip Enrollment
Join us on an enriching journey with the Suwandi Foundation! Our trip enrollment form not only secures your spot for an incredible adventure but helps us prepare for you! Please be sure to fill out this form slowly and honestly – your answers to these questions help us get to know you better so we can ensure this trip can be the best experience for you. After submitting this enrollment form please check your email, as you will receive your next steps within 1-2 days from our Volunteer Coordinator, Komang Ari. We can’t wait to see you in Bali! Terima Kasih 🙂
Your Personal Information
Your details, your way. In this section, we’re collecting some basic information to make sure we know who you are and how to reach you. Rest assured, your privacy is a top priority. The data you provide here is strictly for program purposes, and we’ve got safeguards in place. So, take a moment to fill in the blanks, and let’s get to know you better. Your information is in good hands, and we appreciate your openness in helping us make your experience tailor-made for you!
Your Name
(Required)
First
Last
Your Email Address
(Required)
Enter Email
Confirm Email
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Your Phone Number
(Required)
Include your country’s phone code. Example: +1
Participant Cell Phone Number While Traveling
(Required)
Include your country’s phone code. Example: +1
Birthdate
(Required)
MM slash DD slash YYYY
Age: Age you will be while participating in your Suwandi Foundation program.
(Required)
Passport Number
(Required)
Passport Expiration Notice
(Required)
Your passport must not expire within 6 months of the date you leave Indonesia. Without 6 months of validity, you will not be permitted into the country of Indonesia.
My passport does not expire within 6 months after the date I return from my trip.
My passport does expire within 6 months after the date I leave Indonesia. I am in the process of renewing my passport and will ensure it arrives before my departure to Indonesia.
I have already had a consultation phone call with a Suwandi Foundation Trip Coordinator.
(Required)
Before you can submit your enrollment form it is required that you have met with a Suwandi Foundation Trip Coordinator. If you have not had a call, please stop filling out this form and set up a call here:
https://calendly.com/suwandifoundation23
I have already met with a Suwandi Foundation Trip Coordinator.
Your Trip Details
It’s time to mark your calendar! In this section, we’re narrowing down the dates for our upcoming trip. Take a moment to choose the dates that fit your schedule best. We appreciate you being part of this exciting journey. Let’s lock in those dates and get ready for an amazing experience together!
Trip Type
(Required)
What type of trip will you be participating in?
Teaching Immersion
3 Week – Service Learning
Custom Trip
3 Week Trip Date Options
(Required)
Summer 2 (3 weeks): July 13 – August 03
Summer 3 (3 weeks): August 3 – August 23
New Years Trip (2025): January 4 – January 24
Trip 2: Arriving in Bali Saturday, July 13 & Departing from Bali Friday, August 2nd
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Trip 3: Arriving in Bali Saturday, August 3rd & Departing from Bali Friday, August 23rd
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
New Years Trip: Arriving in Bali Saturday, January 4th, 2025 & Departing from Bali Friday, January 24th, 2025
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Teaching Immersion Trip Date Options
(Required)
All teaching immersion trips are 4 weeks however, they can be extended beyond this for an additional cost per week. Please talk to our team before you leave to organize this, or, if you are loving your time on the ground let us know and we are happy to help you extend your stay.
Fall 1: August 31st – September 27th
Fall 2: October 5th – November 1st
Fall 3: November 2nd – November 29th
Fall 4: November 16th – December 13th
Spring 1: January 25th- February 21st
Spring 2: February 22nd – March 21st
Spring 3: March 22nd – April 18th
Spring 4: April 19th – May 16th
Fall 1: Arriving in Bali Saturday August 31st & Departing from Bali Friday September 27th
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Fall 2: Arriving in Bali Saturday October 5th & Departing from Bali Friday November 1st
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Fall 3: Arriving in Bali Saturday November 9th & Departing from Bali Friday November 29th
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Fall 4: Arriving in Bali Saturday November 16th & Departing from Bali Friday December 13th
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Spring 1: Arriving in Bali Saturday January 25th & Departing from Bali Friday February 21st
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Spring 2: Arriving in Bali Saturday February 22nd & Departing from Bali Friday March 21st
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Spring 3: Arriving in Bali Saturday March 22nd & Departing from Bali Friday April 18th
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Spring 4: Arriving in Bali Saturday April 19th & Departing from Bali Friday May 16th
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on the Saturday stated above and are expected to leave our accommodation on the Friday stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Your Trip Dates
(Required)
These must be pre-approved and discussed with a Suwandi Foundation Trip Coordinator. If you have not set up a call to discuss this, please set up a call… https://calendly.com/suwandifoundation23/60min
I understand that I will be expected to purchase a ticket arriving on a Friday and departing on a Saturday.
(Required)
Check the box to confirm you understand your arrival and departure dates. *If you plan to explore Bali/Indonesia before or after, please note you must be at the airport on a Saturday as stated above and are expected to leave our accommodation on a Friday as stated above. Any requested stay beyond this will be an additional cost.
I understand the dates I need to purchase my ticket for.
Participant Background Information
Let’s get to know you better! This section dives into your previous experiences and the reasons behind choosing this trip. Share a bit about your past adventures and why this one caught your eye. Your unique insights help us tailor the experience just for you. So, take a moment to provide brief descriptions. Whether you’re a seasoned explorer or a first-time adventurer, your story matters. Thanks for letting us in on your background – it’s the key to crafting a journey that’s perfect for you!
What best describes this trip?
High School Student Summer Travel
University Student Break Travel
High School Gap Year
College Gap Year
Other
Previous Experience Working with Children
Please list 1-3 experiences you have had working with children.
Service Type
Dates
Position
Tell Us More
Add
Remove
Previous experience traveling out of your home country
Please list your 3 most recent travel experiences. If none, please leave blank.
Location
Dates
Tell Us About Your Experience
Add
Remove
Is there anything else you would like to share with us?
Maximum 250 words
Health History
The following section is our Participant Health History and Emergency Contact form. It must be completed honestly, accurately, and completely by every Participant over the age of 18 or by the parent/guardian of a Participant under the age of 18. This information will only be shared as necessary with our staff, contracted partners, or others that will be directly responsible for ensuring the safety and wellbeing of the Participant and will remain protected and considered confidential to the best of our ability. Completion and review of this health history information is required for each Participant before traveling and a core element of our health and safety system. Our ability to clearly understand pre-existing medical, physical, or mental health conditions allows us to address and potentially limit threats based on the remoteness of program locations, activities involved, and potential limitations available within the areas we visit. We strongly advocate that all Participants collaborate with their physician, therapist, or other personal care professionals about the specific program location, travel needs, and activities listed in the program itinerary while completing this form. Your openness and accuracy in sharing this information are crucial in ensuring a safe and enjoyable experience for everyone. Thank you for prioritizing your health on this journey!
I. Emergency Contact Information
Please ensure at least one emergency contact is a proficient English speaker.
Primary Emergency Contact Name
(Required)
First
Last
Relationship to Participant
(Required)
Home Phone
(Required)
Include your country’s phone code. Example: +62, +1, +44, etc.
Cell Phone
(Required)
Include your country’s phone code. Example: +62, +1, +44, etc.
Email
(Required)
Address
(Required)
State / Province / Region
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Secondary Emergency Contact Name (Optional)
First
Last
Relationship to Participant
Email
Home Phone
Include your country’s phone code. Example: +62, +1, +44, etc.
Cell Phone
Include your country’s phone code. Example: +62, +1, +44, etc.
Address
State / Province / Region
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
II. Insurance Information
Basic travel insurance with coverage for South East Asia / Indonesia specifically is required for all participants in our program. You may purchase this through any travel insurance provider of your choice. You will be required to upload proof of insurance before your arrival. Please note that domestic health insurance typically does not cover expenses or claims made outside the Participant’s country of residence. We recommend checking with your domestic insurance carrier to understand coverage limits.
Please enter your domestic health insurance policy information below:
Please carry a copy of your insurance and prescription cards while on your program.
Name of Carrier / Provider
(Required)
Group / ID #
(Required)
Contact Phone Number
(Required)
Agreement that you will purchase health insurance with South East Asia/Indonesia coverage for your entire length of stay with us.
Consent to Purchase Insurance on Behalf of Participant
(Required)
By checking the box below I agree to purchase health insurance with coverage for South East Asia/Indonesia before I leave my home country. The coverage must be in place for the entire duration of my stay with The Suwandi Foundation.
I further understand that travel insurance will supplement any existing insurance coverage I may have and is not a substitute for personal insurance. The Suwandi Foundation shall not be held responsible for any gaps in coverage or for any claims that are not covered by the insurance policy.
By checking this box and signing below, I acknowledge that I am required to purchase individual health insurance with South East Asia/Indonesia coverage for my entire length of stay with The Suwandi Foundation.
III. Known Allergies
Please list all known allergies (including but not limited to food [nuts, shellfish, and others], insects, plants, medications, etc.) and describe triggers, symptoms, and severity of reaction (including possible anaphylaxis).
Have you been prescribed epinephrine (ex: Epi-Pen) for any allergies?
(Required)
If yes, please bring at least two epinephrine injections in addition to all other allergy medications as prescribed.
Yes
No
Do you have any known allergies?
(Required)
Please let us know about any and all allergies you may have.
Yes
No
Allergy 1:
Reaction Type or Description of Reaction Symptoms:
Severity of Reaction:
Treatment of Reaction:
Allergy 2:
Reaction Type or Description of Reaction Symptoms:
Severity of Reaction:
Severity of Reaction:
Allergy 3:
Reaction Type or Description of Reaction Symptoms:
Severity of Reaction:
Treatment of Reaction:
Additional Information:
IV. Medications
Please list all prescription medications that the you will take while on the Suwandi Foundation program. Remember to bring adequate quantities of medication(s) to last the entire duration of the program + 1 week extra in case of emergency. Keep prescription drugs in original packaging that identifies the prescribing physician, the name of the medication, the dosage, and the frequency of administration. This is particularly important for entering into and transferring through international destinations. (List additional medications or notes in the Additional Information section at the end of this section.)
Do you take any medications?
(Required)
If yes, please list any and all medications you will be taking during your time in Bali.
Yes
No
Medication 1:
Reason For Medication:
Dosage:
Frequency of Dosage:
Side effects of medication:
Effects of missed dose:
Medication 2:
Reason for medication:
Dosage
Frequency of dosage:
Side effects of medication:
Effects of missed dose:
Medication 3:
Reason for medication:
Dosage:
Frequency of dosage:
Side effects of medication:
Effects of missed dose:
Are there any medications you are currently taking that you will NOT be taking during the program?
(Required)
Yes
No
Are there any medications you are not currently taking, but that you plan on taking before and/or during the program?
(Required)
Yes
No
If yes, please explain:
Additional Information:
V. Health History/Background
Please answer the following information as honestly and accurately as possible. If answering “Yes” to any questions below, please provide specific details when prompted. (Please list additional health history conditions or other important notes in the Additional Information section at the end of this form.)
Do you have any respiratory issues such as asthma?
(Required)
Yes
No
If yes, what type, severity, and treatment?
Do you have diabetes?
(Required)
Yes
No
If yes, please describe current health plan, activity level, and any special needs while on program (i.e. refrigeration of insulin).
Do you have any neurological conditions such as seizures or epilepsy?
(Required)
Yes
No
If yes, what type, history of symptoms, date of last episode, current status, and treatment plan.
Do you have any chronic or recurring illness?
(Required)
Yes
No
If yes, describe what type and any current activity limitations.
Have you had a head injury or concussion within the past 12 months?
(Required)
Yes
No
If yes, provide date of injury(s), any current post concussion symptoms, and date of medical clearance to perform normal activity(s).
Have you been hospitalized within the past 12 months for injury, illness, substance abuse/addiction, or mental health condition?
(Required)
Yes
No
If yes, provide dates of in-patient hospitalization, description of injury/illness, condition, and any current limitations to activities.
Have you had or do you currently have an eating disorder?
(Required)
Yes
No
If yes, please provide the type of disorder, daily caloric goal, food preferences, and current status.
Have you had suicidal or destructive thoughts within the past 12 months?
(Required)
Yes
No
If yes, how often, date of last attempt/thoughts, and any hospitalization received including length of stay?
Have you engaged in any form of self-harm within the past 12 months?
(Required)
Yes
No
If yes, describe what type, date of incident(s), and current status.
Are you or have you been addicted to or abused a substance?
(Required)
Yes
No
If yes, describe substance, dates of treatment (if applicable), and current status.
Have you seen a mental health professional within the past 12 months?
(Required)
Yes
No
If yes, provide condition(s), frequency of visits, date of last visit, and current mental health status.
Additional Information:
VI. Swimming Ability
Please give us a basic description of your swimming ability. Note: Please let us know if you have concerns about participation in water-based activities, or if you have a fear of the water.
What is your swimming ability in calm water (a pool or a small lake):
Non-Swimmer: I do now know how to swim.
Poor: I cannot swim or tread water for at least 5 minutes but know how to perform at least one swimming stroke.
Competent: I can swim/tread water for at least 10-15 minutes and am proficient with at least one swimming stroke.
Advanced: I can swim/tread water for at least 20 minutes and am skilled in two or more swimming strokes.
Indicate your swimming ability in moving water or water with currents (an ocean or moderate river rapids):
Non-Swimmer: I do not know how to swim.
Poor: I cannot swim or tread water for at least 5 minutes but know how to perform at least one swimming stroke.
Competent: I can swim/tread water for at least 10-15 minutes and am proficient with at least one swimming stroke.
Advanced: I can swim/tread water for at least 20 minutes and am skilled in two or more swimming strokes.
Additional Information:
VII. Dietary Restrictions
We want to make sure your dining experience is as delightful as the rest of your journey. Please let us know of any dietary restrictions so we can inform our local staff and ensure the best possible preparations for you. Your comfort and satisfaction are our priorities, and your input helps us tailor our offerings to meet your needs.
Do you have any medical dietary requirements?
(Required)
Yes
No
If yes, please explain:
Do you have any personal or religious dietary restrictions?
(Required)
Yes
No
If yes, please explain:
VIII. Additional Information
Please use this section to describe any condition(s) or limitation(s), which may affect your well-being, the well-being of others, or affect your ability to engage in all activities listed in the program itinerary.
Additional Information
Official Forms + Releases
This section is all about making things official. Please take a moment to read through these forms and understand what you are consenting to. These forms ensure that everyone is on the same page, protecting both you and us. They cover things like consent, permissions, and other important legal information in addition to covering some of your expectations and ours. Your cooperation in this section helps us create a smooth and secure enrollment process. Thank you!
Participant Enrollment Agreement
Please read this participation enrollment agreement (the “agreement”) and all related documents and agreements referenced in this agreement carefully before signing. This document includes a release of certain legal rights. The undersigned participant, and minor participant’s parents and/or legal guardian(s) (collectively “we” or “participant”) hereby agree to the terms and conditions stated herein as consideration for The Suwandi Foundation (“organization”) or (“Assistants”) permitting the participant to enroll and participate in organization programs (collectively, the “program”). Although not a legal requirement, The Suwandi Foundation recommends all Participants over the age of 18 share this document with their parents and legal guardians to ensure all parties understand the legal obligations of the included terms.
Participant Enrollment Agreement
(Required)
1. MEDICAL AUTHORIZATION AND RELEASE
A. Medical Authorization and Consent
We authorize and consent to organization and its Assistants and such entities’ organizers, guides, leaders, staff, directors, nominees, assigns, designees, owners, successors, affiliates, local partners, and any and all other persons or entities associated with it, including subcontractors and vendors (collectively, the “Staff”), securing any and all medical attention and treatment which the Staff deems necessary or appropriate for the Participant at any time during the Participant’s program (the “Program”).
Without limitation, we further authorize and consent to the hospitalization, securing and performance of medical treatment, injection, anesthesia, x-ray procedures, blood transfusions, medications and surgery for the Participant by the Staff and/or any hospital, physician, medical care provider, person or entity during the Program in the event the Participant is incapable of making medical decisions independently. We also agree to the release (to or by the Staff) of any records necessary for treatment, referral, billing or insurance purposes.
We acknowledge our full authority to provide this authorization. We understand the Staff will attempt to notify the Participant’s parent/guardian or other designated emergency contact of any medical treatment that has been administered by the Staff or providers or persons who are not part of the Staff as soon as possible for any participant under the age of 18 years of age. We recognize, however, that notification prior to treatment is not always possible in emergency situations or where immediate means of communications are not readily available. Participants over the age of 18 years of age are expected to notify their parent/guardian or other designated emergency contact of any and all medical or mental health treatment and may rely on Staff to assist with this notification.
Due to the isolated and remote locations and conditions that the Participant will encounter on the Program, we understand the availability, accessibility, and quality of medical services and rescue possibilities may be severely limited or even unavailable. There also may be a limited ability to communicate with rescue and medical personnel and to transport or evacuate the Participant from an incident location. Portions of the Program may occur in locations as much as several hours from any medical facility, and in regions where traditional Western medical care is not always available.
The Medical Authorization and Consent to the Staff, as contained in this Section of Part 1 of this Agreement, shall remain in effect during the pendency of the Program only. For purposes of this Section, the Program commences upon the Participant’s arrival and, where applicable, clearance of customs at the arrival airport (“Arrival Airport”) which will occur on the Program starting date communicated to Participant. The Program concludes upon the Participant’s leaving the departure airport (“Departure Airport,”), which will occur on the ending date communicated to Participant, unless the Participant departs at an earlier time. Neither Organization nor its Assistants will be liable for any damages, injuries, illnesses, or any other harms sustained by the Participant before the Program begins or after the Program ends.
B. Mental Health Support
We understand that the Staff are trained first and foremost in the field of experiential education. The Staff is not qualified in any way to deliver any psychiatric or mental health support or treatment. Organization programs are not therapeutic and do not provide any mental health treatment or support. They should not be used or recommended as a component of a mental health treatment regimen. The Staff is neither trained, competent to or able to provide support, accommodation or treatment to students struggling with substance abuse or mental health issues . If mental health consultation or treatment becomes necessary during a program in response to a particular situation, Organization may, but shall not be obligated to, make a reasonable effort to facilitate it. If necessary, the Participant in such a situation, may be removed from the Program.
C. Right to Refuse
We understand and agree that, subject to applicable law, Organization reserves the right to refuse Participant from participating in any of Organization’s Programs for any lawful reason, in Organization’s sole discretion. We represent that the Participant is adequately physically and mentally fit and prepared for this type of travel, living abroad and for the activities that are associated with the Program. If Participant requires any specialized physical, mental health or academic accommodations, Participant shall disclose and request such accommodation pursuant to Part 1.D. below. We acknowledge that we have the sole responsibility to share all medical and mental health information with the Staff during enrollment. Such medical information shall be shared with Organization or with an Assistant designated by Organization. If Organization learns that a healthcare professional has determined that participation in a particular activity or Program is not advised, Organization may, subject to applicable law, prohibit the Participant from engaging in that activity or Program. If Organization obtains information or otherwise determines during the course of the Program that the Participant’s previously undisclosed medical or mental health condition renders the Participant incapable of meeting the Program requirements, Organization may remove that Participant from the Program. This determination is at Organization’s sole discretion. Any costs associated with a participant’s dismissal, including but not limited to additional lodging, food, or travel expenses, will be solely at the Participant’s and/or his/her parent’s or legal guardian’s expense.
2. INSURANCE, MEDICAL EXPENSES, AND PERSONAL PROPERTY
We understand that the Organization includes basic travel insurance for Participants within the cost of program enrollment. This insurance includes emergency medical coverage, emergency dental coverage, and emergency evacuation coverage. The Organization will provide the Participant with details of travel policy coverages and potential deductibles at least 2 weeks prior to the program departure.
The Participant is responsible for understanding the terms of coverage and purchasing any additional coverages relating to personal property, trip cancellation, trip delay, or cancellation for any reason reimbursements. Any amount owed as a deductible to activate the included travel insurance coverage remains the responsibility of the Participant. Additionally, if the Participant is responsible for acquiring any additional or increased travel insurance coverage amounts due to pre-existing conditions, medical needs, or personal preferences.
If any type of medical treatment is required for the Participant for any reason, we understand and accept full and exclusive responsibility for any expenses not covered by Organization’s included travel insurance policy. The Staff may, but is not required to, provide initial payment to secure urgent medical services for Participant, and in such situations, we agree to reimburse the Staff no later than ten (10) days after payment is made by the Staff to secure such medical services. We accept and acknowledge that regardless of the type of injury or illness that the Participant may sustain, the cost of any and all medical care and assistance before, during, and after the Program is exclusively our responsibility.
We agree to hold harmless and indemnify (“indemnify” meaning protect by reimbursement or payment) Organization and its Assistants of and from any and all expenses arising because of any claim which may be presented by anyone including any health care provider or other third party, for expenses, loss, or damage as a result of the Participant’s healthcare before, during, or after the Program. We also agree to accept all risk and fully release Organization and its Assistants for any personal property loss or damage the Participant may sustain during and/or resulting from participation in the Program.
We understand that throughout Participant’s participation in the Program, including without limitation during the Program’s activities (see Part 3) and while staying at Accommodations (see Part 4), there exists the risk that Participant’s personal property may be subject to damage or theft. We assume all risks associated with regard to Participant’s personal property, and we fully release Organization and its Assistants for any damage, theft, or loss of any of Participant’s personal property that occurs during the Program.
3. ACTIVITIES AND WAIVER
We hereby give permission to allow the Participant to engage in the optional and included activities communicated to Participant in connection with the Program. These activities vary from program to program and relate to the program focus, itinerary, environmental conditions and staffing. Some of these activities may not be part of the Program cost and may require an additional cost (this additional cost may be collected by Organization or its Assistants). We understand that Organization and its Assistants reserve the right, at any time, including before or during the Program, to change any planned activities, including making cancellations, substitutions, or any other changes, at their sole discretion. We understand that, to the extent possible, Organization will contact us about any changes to any planned activities. Further, we understand and agree that Organization and its Assistants will not be responsible for any costs incurred as a result of a change to any planned activities.
If a Participant chooses to not participate in any given activity included within the Program, Participant will inform Organization ahead of time. Organization cannot guarantee that an alternative activity will be made available to Participant. Organization does not refund Participant for any missed activities. .
4. ACCOMMODATIONS DURING THE PROGRAM
We understand that Participant’s accommodations during the program may be a combination of lodging provided by educational institutions, Yayasan Loka Mawa Upadhi, Khrisna Sunrise Accommodation, hotels, and/or villas (collectively, the “Accommodations”). Due to the nature and location of Organization programs, it is likely the Participant will be staying in Accommodations that maintain no insurance and are in no way required or even able to obtain insurance. Therefore, we understand that Organization strongly recommends that we obtain insurance with coverage limits sufficient to cover the value of the Participant’s personal property, in the event of theft, fire, flood, or other unforeseen occurrence. We acknowledge that Organization is not responsible for Participant’s property.
5. DEPOSITS, PAYMENTS, CANCELLATIONS, AND REFUNDS
Payments: All programs require payment of a $250 non-refundable deposit for each Participant to confirm their spot on the program. Participants are expected to pay 100% of their total program cost at least 1 month prior to the program departure date. Any booking made within 1 month of the program’s departure will need to be paid in full including the application fee at the time of enrollment.
Cancellations: The Organization offers refunds for cancellations as follows:
– 100% (full refunds) of all money paid, minus the deposit, for any cancellations made more than 75 days prior to the program departure date.
– 50% refund of all money paid, minus the deposit, for any cancellations made more than 45 days prior to the program departure date.
– No refunds of any money paid for cancellations 30 days or less prior to the program departure date.
NOTE: If a credit card was used to make payments, this same card will automatically be credited for any refunds offered as per the refund and cancellation terms listed above unless the Organization is advised of an alternative payment method.
6. TRANSPORTATION
As part of the Program, Organization or its Assistants will book certain ground transportation during the Program (the “Program Travel”). We understand that we are responsible for all costs associated with Program Travel, including but not limited to airfare and carfare. We understand that we are solely responsible to insure and possess all appropriate documentation for travel abroad with the exception of travel visas. Further, we understand that we are solely responsible for arranging and paying for all transportation other than the Program Travel. The type of travel that is excluded from Program Travel includes, without limitation, transportation to the Arrival Airport designated by Organization in the city where the Program will begin, transportation from the Departure Airport designated by Organization in the city where the Program will conclude, and any local transportation within each city the Program will take place in, including but not limited to local public transportation and taxi cabs.
7. MISCELLANEOUS TERMS
A. Compliance with Organization’s Student Handbook and Code of Conduct
We understand that by executing this Agreement, the Participant agrees to follow the rules and regulations described in Organization’s Student Handbook (the “Handbook”), which will be provided prior to the start of the Program and the Organization Student Code of Conduct (the “Code of Conduct”). We acknowledge that Organization may dismiss a Participant as laid out in the Handbook or Code of Conduct, including for wrongful or offensive conduct. Such wrongful, unsafe, or offensive conduct includes, but is not limited to, causing harm to one-self or others; causing harm to properties or local community relationships, and impacting the enjoyment of other participants on the Program. Any costs associated with a Participant’s dismissal, including but not limited to additional lodging, food, or travel expenses, will be at the Participant and his/her parent’s or legal guardian’s expense.
We understand that Organization may amend the Code of Conduct at any time, but Organization will provide reasonable notice to Participants of any policy implemented during the Program that may result in a Participant’s dismissal from the Program.
We also understand that engagement in prohibited conduct, including conduct prohibited in any code of conduct, or other set of rules or policies, may result in dismissal from the Program.
B. Participant’s Behavior
We understand that each foreign country has its own laws, culture and standards of acceptable conduct, including dress, manners, morals, politics, drug use and behavior as outlined in Organization’s Student Code of Conduct which has been provided to us concurrently with this Agreement. We recognize that behavior which violates those laws or standards could harm Organization’s relations with those countries and the institutions therein, as well as Participant’s own health and safety. Participant is aware that if Participant violates the laws of the host country, Participant may place him or herself in legal jeopardy and that U.S. standards of due process may not apply. We understand that Participant is responsible for becoming informed of, and abiding by, all such laws and standards for each country Participant will visit as part of the Program and during designated independent time outside of the Program.
We understand and agree that Participant will attend to any legal problems Participant encounters with any foreign nationals or government solely at Participant’s own expense. Further, we understand that, while Organization will use its best efforts to assist the Participant, neither Organization nor its Assistants is responsible for providing Participant with legal representation. We agree to hold harmless and indemnify Organization and its Assistants of and from any and all expenses incurred by Organization and its Assistants arising from Participant’s violation of any laws of any host country, or assistance provided by Organization.
C. Acknowledgement and Assumption of Risks & Release and Indemnity Agreement
We have read, understand and agree to the terms of Organization’s Acknowledgement and Assumption of Risks & Release and Indemnity Agreement, which has been provided to us concurrently with this Agreement.
D. Photography and Media Use
We understand that Organization and its Assistants reserve the right to capture photographic, video, written, spoken, and other digital or analog media records (“Media”) of any of its programs and the Participants. We understand that the Media may capture Participant’s name, voice, and likeness (“Appearance”). We hereby assign all right, title, and interest that we may have in the Media, as well as any reproduction, product, or derivative work of the Media. The foregoing assignment includes the right of Organization to use the Participant’s name to identify the Participant in the Media. We hereby waive any right to inspect or approve Organization’s use of the Media and we release Organization, its affiliates, partners, employees, officers, licensees and assigns from any and all claims arising out of the use of the Media, including, but not limited to, invasion of privacy or rights of publicity, or any claims for consideration or compensation for my Appearance or the rights granted hereunder. We agree that Organization and its Assistants may use any Media of the Participant for promotional and/or commercial purposes, whether taken before, during, or after the Program. We understand that Organization and its Assistants cannot control any Media taken or produced by outside parties not affiliated with Organization or its Assistants, and we fully release Organization and its Assistants and Staff for injury or damages suffered as a result of any Media taken or used by any such outside parties.
E. Assistants
We understand and agree that Organization may, at Organization’s sole discretion and expense, employ or engage the services of such employees, subcontractors, partners or agents, as Organization deems
necessary to provide the Program and associated activities (“Assistants”). Organization’s Assistants may also use their own vendors and subcontractors.
F. Disclosure of Sensitive Communications
We understand that Organization and its Assistants reserve the legal, ethical, and moral right to determine whether to report to the Participant’s parents or guardians anything the Participant shares while on a Organization program regarding the personal history of threatened or performed abuse; physical, sexual, or mental assault; or any other act that jeopardizes that Participant’s well-being. If the Participant is 18 years of age or older, Organization or its Assistants will obtain the Participant’s permission first unless the situation is deemed serious or life threatening. In these circumstances, Organization and its Assistants reserve the right to communicate with parents without consent in the interest of the Participant’s safety and wellbeing.
G. Governing Law, Venue, and Dispute Resolution
We agree that California law (without regard to its “conflict of laws” rules) exclusively governs this Agreement, and any dispute we have with Organization and its Assistants, and all other aspects of Participant’s relationship with Organization and its Assistants, contractual or otherwise (collectively, a “Dispute”), without giving effect to principles of conflicts of law. In the event of a Dispute, the parties will first attempt to resolve the Dispute(s) through good faith negotiation. In the event that the Dispute(s) cannot be resolved through good faith negotiation, the parties will refer the Dispute(s) to a mutually acceptable mediator, the costs of which shall be divided equally between the parties. In the event that such Dispute(s) cannot be resolved through mediation, the parties will refer the Dispute(s) to the American Arbitration Association for resolution through binding arbitration by a single arbitrator pursuant to the American Arbitration Association’s rules applicable to commercial disputes. Any mediation or arbitration hereunder will be held in the United States of America, California. In the event that the dispute resolution procedures in this Section are found not to apply to a given Dispute, or in the event of a claim for injunctive relief, the parties agree that any judicial proceeding will be brought in the state courts of the United States of America, California. The parties consent to venue and personal jurisdiction there. The parties agree that, in the event of arbitration (or in the event of a lawsuit if this arbitration clause is deemed invalid or does not apply to a given Dispute) the prevailing party shall be entitled to costs and fees (including reasonable attorneys’ fees).
I. Severability
Should any provision of this Agreement be held to be void or unenforceable, the remaining provisions shall remain in full force and effect.
J. Amendments and Waiver
No modification of or amendment to this Agreement, nor any waiver of any rights under this Agreement, shall be effective unless in writing signed by the parties to this Agreement. No delay or failure to require performance of any provision of this Agreement shall constitute a waiver of that provision.
K. Entire Agreement
This Agreement, including all documents and policies referenced herein, sets forth the entire agreement and understanding of the parties relating to the subject matter herein and supersedes all prior or contemporaneous discussions, understandings and agreements, whether oral or written, between them relating to the subject matter hereof.
L. No Third Party Beneficiary
This Agreement is intended for the benefit of the parties hereto and their respective permitted successors and assigns, and is not for the benefit of, nor may any provision hereof be enforced by, any other person or entity.
9. ACKNOWLEDGEMENT AND AGREEMENT
We acknowledge that this Agreement includes a Medical Authorization, a release and waiver of certain legal rights, and other specified contractual obligations between us and The Suwandi Foundation and we sign the Agreement with our own free will. We acknowledge that acceptance of our participation in the Program is dependent upon the complete and timely submission of all required documents and agreements including but not limited to this Agreement and all documents and policies referenced in this Agreement.
By checking this box and signing below, we confirm that we have carefully read, understand, and voluntarily sign this agreement. We acknowledge that it shall be effective and legally binding upon me, my spouse, participant, and other children, as well as participant’s/parent’s other family members, heirs, executors, representatives, subrogees, assigns, and estate. All participants must sign and check this box. If the participant is a minor (those under 18 years of age), one of the participant’s parents or legal guardians must also sign. We understand that our signatures are valid and legally binding whether we choose to electronically sign this agreement, consent to this agreement through any form of click-wrap agreement, or sign a printable version of this agreement.
Child Protection Policy
Safety first! This document spells out our commitment to keeping every child in our program safe and sound. It covers our guidelines, procedures, and the steps we take to ensure a secure environment. By reading and agreeing to this policy, you’re helping us create a protective and nurturing space for everyone. Your commitment to child safety matters, and we appreciate your cooperation in making our program a secure and enjoyable experience for all.
Child Protection Policy
(Required)
Contribute to a positive environment that protects and supports children.
Avoid any situation where you are alone with a child particularly in any type of secluded area where they cannot be observed by others.
Refrain from any action that could be considered physical, verbal, sexual, or mental child abuse.
These forms of abuse may include:
-Physical Abuse: actions such as spanking, slapping, striking, intimidating.
-Verbal Abuse: actions such as humiliating, degrading, threatening.
-Sexual Abuse: actions such as inappropriate gesturing, touching, or language.
-Mental Abuse: actions such as neglecting, degrading, shaming, cruelty, and put downs.
Raise concerns about any case of suspected harm, abuse, neglect or exploitation.
Behave with respect and maturity around children including being sure not to use foul, profane, or derogatory language or inappropriate or intimate gestures around children.
Pay close attention to the safety of children during play and not to engage in rough play.
Inform Suwandi Foundation of any concerns or issues raised by a child.
Never give gifts or donations directly to children unless discussed with the Suwandi Foundation first.
Do not show favoritism to particular children.
Use positive techniques of guidance such as redirection, positive reinforcement, and encouragement rather than competition, comparison, and criticism.
Do not do things for children that they should be able to do for themselves such as dressing, tying shoes, and so forth.
Always seek permission from a child’s parent or legal guardian / caretaker before taking any pictures of children. Do not take photographs of children in distress or that could compromise their dignity.
Always dress and act appropriately in accordance to local cultural values when around children.
Encourage children to play with each other, rather than only yourself?
Fist bumps & high fives at the end of class, no hugs.
By signing below, I understand that violations of The Suwandi Foundation Child Protection Policy can result in conduct probation and even dismissal from the program, which may have additional consequences including loss of course credit or funding, reporting of such violations to the institution that grants credits or funding for participation in the program, and significant cost. Suwandi Foundation does not cover costs associated with early return from the program or offer refunds.
By checking this box and signing below, I understand that violations of The Suwandi Foundation Child Protection Policy can result in conduct probation and even dismissal from the program, which may have additional consequences including loss of course credit or funding, reporting of such violations to the institution that grants credits or funding for participation in the program, and significant cost. Suwandi Foundation does not cover costs associated with early return from the program or offer refunds.
Participant Code Of Conduct
Think of this as our golden rulebook. By agreeing to this code, you’re promising to be a kind and respectful person during our program. It’s all about creating a positive and inclusive experience for everyone involved. Take a moment to go through the do’s and don’ts, and let’s make sure our time together is fun, friendly, and memorable. Your commitment to this code helps us build a fantastic community. Thanks for being an important part of it!
Code of Conduct
(Required)
EXPECTATIONS OF CONDUCT
Participants on Suwandi Foundation programs are expected to behave in a respectful and safe manner towards themselves, other Participants, Suwandi Foundation international staff, learning center students and all local community members during their trip, activities, while volunteering with Learning Center: Yayasan Loka Mawa Upadhi, and while on free time. Enforcing shared responsibility helps to maintain successful and meaningful trips. This Code of Conduct document outlines some of the core expectations of Participant behavior while on a Suwandi Foundation Program. However, this Code of Conduct is not intended to comprehensively cover every type of prohibited behavior or legal obligation to which Participants and their guardians are bound in connection with Suwandi Foundation program and this Code of Conduct is subject to the terms of the Participant Enrollment Agreement and all other rules, policies and agreements to which Participants and their parents may be bound.
PROBATION & PROGRAM DISMISSAL
The Suwandi Foundation reserves the right to immediately dismiss any Participant who places the safety of any other Participant, staff, or themselves at risk by violating expectations while traveling to, from, or on Suwandi Foundation Programs.
When a Participant is dismissed from a program for a breach of our Code of Conduct Policies, no refund will be given for any program costs or flights (whether used or unused). All costs associated with a Participant’s departure from the program will be the responsibility of the Participant and their family. Future participation in Suwandi Foundation programs will not be permitted for Participants dismissed for Code of Conduct Policy violations.
Some actions that are unsafe but don’t directly violate Suwandi Foundation’s zero tolerance guidelines can result in Participant being placed on conduct probation. This probation is implemented as a means of correcting unsafe or irresponsible behavior before serious impacts to program experience or personal wellbeing are experienced. If inappropriate behavior continues, regardless whether this is a continuation of the same action or a pattern of multiple individual actions, Participants will be dismissed from the program.
Probation measures may include, but are not limited to: Removal of privileges such as organized activities or time in the classroom, parent/guardian notification of Participant behavior infractions, and probation status. Repeated behavior can lead to dismissal from the program.
ZERO TOLERANCE GUIDELINES, GROUNDS FOR DISMISSAL
ILLEGAL DRUGS + SUBSTANCES: ZERO TOLERANCE
Participants cannot buy, use, possess, or assist others in acquiring illegal or non-prescribed drugs including marijuana. The Suwandi Foundation is not required to allow – and in fact is subject to affirmative obligations to prohibit — the medical or recreational use of marijuana or any drug while on program, because marijuana is illegal under federal law. In addition, marijuana, cannabis, hash, and products containing CBD or THC are illegal in Indonesia, even for medicinal purposes. Possession of these substances can result in severe penalties including the death penalty, and for this reason, a Participant who is in violation of this will be sent home immediately at their own expense.
UNDERAGED ALCOHOL CONSUMPTION: ZERO TOLERANCE
Participants under the age of 21 can not consume alcohol in accordance with local laws. This program is designed to enrich the lives and experiences of both volunteers and their students, and alcohol consumption contradicts the objectives of the program. There may be situations where Participants younger than the age of 21 are offered alcoholic beverages by local community members or travellers from other places, and we expect them to politely turn it down in order to comply with Suwandi’s Code of Conduct expectations..
For Participants 21 years and older, we highly discourage the use of alcohol. Although anyone over the age of 21 can legally consume alcohol, excessive drinking (binge drinking) or developing a routine or pattern of habitual consumption is not acceptable and may result in immediate dismissal.
CHILD ENDANGERMENT: ZERO TOLERANCE
All Participants will be required to sign The Suwandi Foundation Child Protection Policy which outlines expected behavior around children. If any member of the Suwandi Foundation or Yayasan Loka Mawa Upadhi teams receives a formal complaint or witnesses any Participant’s inappropriate behavior towards local children, the Participant will be required to immediately leave the program at their own expense.
SEXUAL ASSAULT: ZERO TOLERANCE
Sexual harassment is prohibited conduct and is defined as unwanted sexual advances, requests for sexual favors, or visual, verbal, or physical conduct of a sexual nature. Examples of sexual misconduct include but are not limited to: unwanted sexual advances, verbal conduct such as making or using derogatory comments, epithets, slurs, sexually explicit jokes, or comments about any person’s body or dress, and physical conduct such as touching, assault, rape, or impeding and/or blocking any persons movements. Any allegations of sexual harassment or assault caused by a Participant will result in immediate removal from the program, without exception, and may result in legal consequences.
GENERAL POLICIES
All Participants are responsible for their individual acts and omissions, and must abide by Suwandi Foundation’s rules and policies as provided or posted from time to time (“Policies”). Participants who fail to comply with Suwandi Foundation’s Policies may be asked to terminate their participation in the Program without refund. In addition, Suwandi Foundation reserves the right to remove any Participant from any program at any time without refund if their behavior or participation is detrimental to themselves or others, or they consistently disregard staff instructions.
As a Suwandi Foundation Participant, you have a shared responsibility to ensure that your program is safe, fun, and meaningful. During your program, we expect that you always follow the policies below.
BULLYING AND INCLUSIVITY
At Suwandi Foundation, we value community. We cherish diversity and inclusivity, and we actively strive to create a culture of acceptance, tolerance, and respect. We welcome all Participants onto our program, regardless of race, ethnicity, gender identity, sexual orientation, religion, or socioeconomic status. We have intentionally included bullying and other exclusive behaviors in our expectations of conduct.
GIFT GIVING & BUYING FROM CHILDREN
Participants are prohibited from purchasing gifts for any students or children, or engaging in any transactions with them. There may be instances where children are selling bracelets they have made, either at school or in public, and it may be tempting to support their small business. However, often these children are compelled to work as salespeople by their families. The Suwandi Foundation and our partners do not endorse child labor, and by supporting their business, you are perpetuating a cycle where even children under 10 years old are forced to work.
Similarly, participants are not permitted to give gifts to specific children. If you wish to provide items to your students, you must ensure that each item is provided for every single student in your class. The most effective way to support the children you will be serving is by purchasing school supplies and bringing them with you to Bali as donations. Examples of such supplies include glue, tape, stickers, child scissors, cardstock, paint, etc.
INTERACTIONS WITH STUDENTS
All Participants are expected to act as respectful role models for students while in the classroom. This includes dressing modestly, avoiding the use of inappropriate language, modeling healthy relationships and working to create teacher-student relationships rather than friendships. If a volunteer is not capable of following these guidelines they will be asked to leave the volunteer program.
Participants are requested to refrain from hugging students and are prohibited from giving gifts to individuals, as this behavior can be perceived as favoritism and exacerbate the revolving door effect. Any inclination to hug should be replaced with a high-five, and gifts should be provided for entire classes and be school-related items such as pencils, notebooks, etc. Supporting students both in and outside of the classroom is encouraged; however, direct monetary gifts to students or staff members are strictly prohibited. If a Participant wishes to support a local team member or student, they must first discuss it with Suwandi Foundation staff.
During school hours, taking photos is only permitted after obtaining permission from all parties involved. If a student, staff member, or another Participant declines, Participant must respect their decision and refrain from taking the photo.
TOBACCO + NICOTINE PRODUCT USAGE
Students under the age of 18 are not permitted to use tobacco unless written approval is given to them by their parents. Except when such a minor is in a private residence accompanied by the parent or guardian of the minor and with the consent of such parent or guardian, no person under 18 years of age shall have personal possession of tobacco products.
We recognize that nicotine and tobacco are addictive substances and understand that students may have already experimented with these products. If this is the case, an agreement between the student, instructors,
and office staff can be made to allow the student access to approved tobacco products. A Suwandi Foundation program is not the setting for new experimentation and this policy does not support anyone starting the use of tobacco products.
EXCLUSIVE RELATIONSHIPS
If students are interested in beginning a romantic relationship within their group, they are expected to first check in with their instructors to review Suwandi Foundation bullying and inclusivity statements. Overtly exclusive relationships, including clique forming, are not permitted on a Suwandi Foundation program. This includes sharing beds with a partner, asking others to leave a room to be alone with a partner, removing oneself from group experiences to be with a partner, or publicly displaying affection during group activities or in situations where it is inappropriate. Should a relationship become an ongoing issue within the group, it may result in you being sent home at your own expense.
The Suwandi Foundation does not allow program Participants to form romantic or sexual relationships with any person outside of the group you are volunteering with. Different cultures have different expectations and values around physical and romantic relationships and it is important to respect those and respect the fact that we might not fully understand them. For this reason, romantic relationships outside of the group are not permitted.
FREE-TIME
Participants must provide proper notification to staff and fellow Participants AND be given permission by Suwandi Foundation staff to leave the accommodation premises if they want to engage in non-scheduled exploration including but not limited to their weekend time. Participants must inform and meet with a Suwandi Foundation team member before participating in any activity not sponsored by The Suwandi Foundation Examples include utilizing ride sharing services and public events. Participants may be required to fill out an Independent Travel Agreement Form if they will be travelling on their own. During any and all free time the Suwandi’s Code of Conduct and Child Protection Guidelines remain in effect and participants are expected to adhere to these guidelines at all times, including during independent travel.
SAFETY EXPECTATIONS
Participants must adhere to all safety information and guidelines provided by Suwandi Foundation’s staff and the staff of our partnered organizations. Participants are expected to maintain their own health precautions such as taking prescribed medications on time, not putting themselves in dangerous positions, staying generally aware of their surroundings and practicing basic health and hygiene.
Participants are expected to read and familiarize themselves with the US Department of State Travel Advisories inIndonesia as well as Center for Disease Control Vaccination recommendations before arriving.
SOCIAL MEDIA & MANDATED REPORTING
If a student or child from the community you are volunteering in requests to follow you on your personal social media accounts, we strongly advise you to carefully consider before granting them access. If your social media pages contain any inappropriate content, such as material you would not consider suitable for a PG-13 audience, we urge you not to allow your students to view your account.
In the event that they do gain access to your social media or personal phone number, you will be obligated to report any inappropriate or concerning interactions that occur. It will be your responsibility to report any signs of suspected child abuse or neglect, including instances of physical, emotional, or sexual abuse, as well as
neglectful or hazardous living conditions. Additionally, you must remain attentive to any disclosures made by children or vulnerable adults regarding their safety and well-being. It is imperative for mandated reporters to remain vigilant and proactive in identifying potential signs of harm, thereby ensuring the protection and welfare of those they serve.
You will also be required to report any instances in which a child asks for any form of financial support, such as cash wiring or student sponsorships. The Suwandi Foundation and our partners provide opportunities for financial aid and sponsorship, so we ask that if a child reaches out for monetary assistance, you immediately report it to a member of our staff.
MOTORCYCLES, ATVs, E-SCOOTERS
Participants are not permitted to rent, ride on, or drive motorcycles, ATVs, or scooters unless they have received prior approval from the Suwandi Foundation staff, with special circumstances discussed in advance with the directors of our partner learning center: Yayasan Loka Mawa Upadhi. This type of activity is particularly risky. For any approved special cases, Participants may only ride on a motorbike, ATV, or E-Scooter with a driver who is licensed in Indonesia. This policy is implemented to mitigate the risk of accidents, injuries, and potential harm to volunteers.
By checking this box and signing below, I understand that violations of the code of conduct and Suwandi Foundation program rules can result in conduct probation and even dismissal from the program, which may have additional consequences including loss of course credit or funding, reporting of such violations to the institution that grants credits or funding for participation in the program, and significant cost. Suwandi Foundation does not cover costs associated with early return from the program or offer refunds.
Enrollment in U.S. State Department STEP Program *US CITIZENS ONLY
[https://step.state.gov/]. By signing up for the US Department of State Smart Traveler Enrollment Program (STEP), you are taking a proactive step towards ensuring your safety and well-being during our service learning trip. This program will provide you with vital information and support, fostering a secure and informed environment for a meaningful experience and is a requirement for all US citizens on our trips.
U.S. State Department STEP Program
I acknowledge and agree to enroll in the Department of State Smart Traveler Enrollment Program (STEP) for the duration of my participation in The Suwandi Foundation’s Service Learning program.
The STEP program is a free service provided by the U.S. Department of State for U.S. citizens traveling or living abroad. By enrolling in STEP, I will receive important information from the U.S. Embassy or Consulate in the country I am visiting, including travel alerts, updates, and assistance in case of emergencies.
I understand that it is mandatory to complete the enrollment process by visiting the Department of State STEP registration page: [https://step.state.gov/].
I agree to sign up for STEP
Select this box if you are not a U.S. Citizen
I am not a U.S. Citizen
Electronic Signature
Time to seal the deal! By adding your electronic signature, you’re giving the virtual nod that you’ve read, understood, and agree to all the important stuff in the forms above – the enrollment agreement, child protection policy, code of conduct. In addition you are agreeing to sign up for the Department of State STEP international travel registry. By signing this it’s like saying ‘I’m on board!’ with a digital high-five. Your e-signature is your way of affirming that you’re ready for a great experience, and we’re excited to have you on this journey with us. Please note that failure to comply witt any of the above rules, regulations, and recommendations can result in your removal from The Suwandi Foundation’s program.
Participant Written Name
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Signature
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Parent/Guardian Written Name
If participant is under 18.
Parent/Guardian Signature
If participant is under 18.
Product Name
(Required)
This deposit is used to hold a spot for you on your trip. It is a non-refundable deposit.
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