2025 June China Trip Cultural Exchange Program Application
Parent's Information (For Applicant under 18yrs)
Do you have experience in cultural exchange prior to this program?*
How did you hear about this program? *
Would you consider apply a scholarship? If yes , please go to our scholarship application page to apply.
Would you like to receive updates about the program via email?
If you have already applied for a China travel visa, please let us know the expected date of Visa Approval from China Embassy
General Health & Medicine History ( For the last 12 months)
1. Had a recent injury ?*
2. Had asthma/wheezing/shortness of breath*
3. Had a recent illness?*
4. Had seizures, fainting or dizziness?*
5. Are you allergic to any medication?*
6. Are you allergic to any food?*
7. Are you allergic to animals?*
Mental, Emotional, and Social Health
1. Ever been treated for attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (AD/HD)*
2. Ever been treated for emotional or behavioral difficulties or an eating disorder?*
3. During the past 12 months, seen a professional to address mental/emotional health concerns?*
4. Had a significant life event that continues to affect the applicant's life? *
Medical Consent & Agreement*
Family / Parent Consent Form
Please review the consent form below. If you agree to the terms, type your full name and date. If the applicant is under 18, a parent or legal guardian must also sign and date this agreement.
The undersigned hereby acknowledges and agrees to the following:
1. Participation Commitment
The applicant agrees to fully engage in all trip-related activities and comply with all program rules, policies, and instructions set forth by PCC Education Fund Corporation, its staff, and designated representatives. Applicants are expected to conduct themselves in a respectful and responsible manner throughout the program. Failure to adhere to these guidelines may result in dismissal from the program at the applicant’s own expense, without refund.
2. Use of Media and Materials
The undersigned grants PCC Education Fund Corporation and its authorized representatives the irrevocable right and permission to record, photograph, film, and otherwise capture the applicant/participant’s image, likeness, voice, written work, and statements during the trip/event. These materials may be used, reproduced, distributed, and publicly displayed for promotional, educational, archival, and informational purposes in various media, including but not limited to:
PCC’s official website, brochures, and newsletters
Social media platforms and digital marketing campaigns
Press releases and external media coverage
Educational and recruitment materials
The undersigned waives any right to inspect or approve the final materials and acknowledges that no compensation will be provided for their use. PCC Education Fund Corporation retains full rights to the materials and may use them indefinitely.
3. Liability Waiver and Assumption of Risk
The applicant/participant voluntarily assumes all risks associated with participation in the trip/event. PCC Education Fund Corporation, its staff, affiliated organizations, and partner institutions in China shall not be held liable for any injury, illness, loss, accident, delay, or damage to personal property arising from participation in the program.
Additionally, the applicant/participant and/or their parent/guardian agrees to sign a separate Waiver of Liability Agreement before attending the program.
4. Medical Authorization and Emergency Care
In the event of illness or injury, the undersigned authorizes PCC Education Fund Corporation, its staff, chaperones, and designated personnel in China to arrange and provide medical treatment as deemed necessary. The applicant/participant and/or their parent/guardian understands that all medical expenses, including hospitalization, doctor’s fees, and prescriptions, will be the sole responsibility of the applicant/participant or their family/guardian.
5. Passport, Visa, and Travel Requirements
The applicant/participant is solely responsible for obtaining and maintaining a valid passport and securing any necessary visas required for travel.
Passports must be valid for at least six (6) months beyond the departure date from the United States.
Failure to obtain the required travel documents may result in cancellation of applicant/participation without refund.
6. Program Fee & Refund Policy
The program fee must be paid in full within three (3) days of acceptance into the program. This fee is non-refundable once airline tickets have been purchased. Additional costs, such as visa application fees, personal expenses, and optional excursions, are not covered by the program fee.
7. Application Deadline & Limited Availability
Applications must be submitted as soon as possible, as spaces are limited. Applications without a valid passport may be disqualified.
8.The applicant/participant is aware that the programs, schedules, and itineraries are subject to change due to any unexpected or uncontrollable situations that may occur in the U.S. or China.
By signing below, l confirm that l have read, understood, and agreed tothe terms outlined in this consent form.
Applicant/Participant Signature Date*
Parent/Guardian Signature Date*
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