2017 CEOS Trip to Ireland WHO:

West Virginia CEOS members

WHEN:

Thursday, August 17th, 2017 - Friday, August 25th, 2017

WHERE:

An Grianan, Ireland (approximately 1 hour north of Dublin)

COST:

$3,000.00. The cost above DOES NOT include: • passport fees • any meals on the day of departure from the Unites States • any meals after breakfast on the day of departure from Ireland • any extras that are purchased • transportation to and from the airport Once registration is complete, the Planning Committee will work with those registered to coordinate car pools to either Pittsburgh or Charleston Yeager Airport. Class and accommodation choices will be offered on a first come, first serve basis. The registration forms and a non-refundable deposit of $1,000 must be received by the WVU Extension Office by Friday, October 7th, 2016. Address: PO Box 6031, 609 Knapp Hall, Morgantown, WV 26506-6031

REGISTRATION:

CANCELLATIONS If you cannot attend for any reason, notify the WVU Extension Office as soon as & REFUNDS: possible at the address listed above. Upon receiving written notification, you may be refunded a percentage of the fees minus the non-refundable deposit. Please see the attached document, Payment Details and Refund Policy, for further details. PASSPORT INFORMATION:

Participants will be responsible for securing their own passport prior to the departure of the trip. New passport fees are $165. Allow at least two months to secure your passport. Please contact your local post office to secure your passport.

TENTATIVE SCHEDULE:

The arrival and departure dates are confirmed. Below is the tentative to different dates, depending upon in the host country. Thursday, August 17, 2017 Depart from US Friday, August 18, 2017 Arrival in An Grianan, Ireland Saturday, August 19, 2017 Local Tour Day Sunday, August 20, 2017 Local Tour Day Monday, August 21, 2017 Course Day at An Grianan Tuesday, August 22, 2017 Course Day at An Grianan Wednesday, August 23, 2017 Course Day at An Grianan Thursday, August 24, 2017 Local Tour Day Friday, August 25, 2017 Depart for the US

Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.

PAYMENT DETAILS AND REFUND POLICY 1. Checks are made payable to West Virginia University. 2. Mail Checks to Address: PO Box 6031, 609 Knapp Hall, Morgantown, WV 26506-6031 3. Payment schedule is as follows: a. Non-refundable deposit of $1,000 due Friday, October 7, 2016. b. 2nd payment of $1,000 due Monday, February 6, 2017. c. Final payment of $1,000 due Monday, June 5, 2017. 4. Receipts will be mailed out to participants upon confirmation of registration. 5. Pay the final amount of the trip balance on or before the due date. 6. The program deposit is non-refundable beginning once the participant submits the payment agreement form to the WVU Marion County Extension Office. 7. Upon written notification to the WVU Extension Office, you may petition to withdraw because of serious illness. You MAY be eligible to receive a refund minus program specific non-refundable costs and airline ticket. Medical documentation of inability to participate in the program is necessary in making claims for the refund. Program Balance Refund Policy (Program cost minus deposit) PROGRAM WITHDRAWAL DATE Between 90 days and 60 days prior to departure Between 59 days and 30 days prior to departure Between 29 days and day of departure

REFUND POLICY up to 75% of program cost minus program deposits up to 50% of program cost minus program deposits NO REFUND

Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.

WVU Extension Service Policies & Rules The following policies and procedures will be observed during the 2017 CEOS Trip to Ireland in order to provide a safe environment conducive to positive educational experiences while abroad. Participants are asked to review these rules prior to the registration deadline. Then sign and return the completed rules agreement along with registration materials. PARTICIPATION: Participants are expected to participate in all activities. The only exception will be from those with a signed note from a physician. HEALTH HISTORY & MEDICATION: All participants, CEOS members and faculty/staff, must have a signed health statement in order to attend the 2017 CEOS Trip to Ireland. Forms will be reviewed by a medical professional prior to the trip. If you are taking any medications during the trip, name and dosages MUST be included with the health history form. SPOUSES/FAMILY TRAVELERS: Spouses, family members, and members of your communities are welcome to participate in this educational trip to Ireland. Registration is on a first-come, first-serve basis. EMERGENCIES: If there is an emergency during the CEOS trip, the emergency contact provided on the registration form will be notified. If there is an emergency at home, family members should contact WVU’s Office of International Programs at (304) 293-6955. The faculty member(s) traveling with the group will have an international cell phone that can be used for emergency purposes. PHONE POLICIES: Participants can bring their cell phones on the trip; however, cell phone coverage will depend on the carrier. There are typically additional costs when using cell phones out of the United States. This includes making/receiving calls, sending/receiving text or photo messages, and checking voicemails. Please contact your local cell phone carrier store for more information. SPECIAL DIETARY NEEDS & ALLERGIES: Please indicate on the registration form any special dietary needs. Also, if you have a food allergy, you must have a signed statement from your doctor indicating that you cannot have the specified foods. This includes milk and milk products. ILLEGAL DRUG USE: The use, consumption, or possession of unlawful items, such as illegal nonprescription drugs, is not permitted during this trip. If WVU Extension has a good, solid reason to believe a person has an illegal item or substance in his/her possession, or is under the influence of said substance, the WVU Extension Service has the right to inspect or search the possessions of the person in his/her presence. Participants who violate this rule may be sent home, at their own cost, prior to the trip ending. HOST COUNTRY LAWS: Participants are expected to follow the laws of the host country while abroad and are subject to the host country’s punishments of any laws broken. Participants who violate this rule may be sent home, at their own cost, prior to the trip ending. For more information, refer to http://travel.state.gov. WEAPONS: Instruments that can cause bodily injury to others are not permitted during the trip. That includes but it not limited to fireworks, knives, and firearms. Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.

VALUABLES: Participants should not bring valuables, such as expensive jewelry, on the trip. We will not be responsible for lost or stolen items. You are requested to leave all valuables at home. DRESS: For the event, participants need to dress according to the predicted weather. It is recommended that the participants wear comfortable foot wear. PETS: Pets are not permitted on this trip. DAMAGES: It is the responsibility of the participant to pay for any item they damage or break. In the event WVU Extension Service is unable to determine who caused the damage, the cost may be shared by all those at the event. SEVERE CLAUSE: If a participant seriously disrupts the event by: 1) destructing property, 2) overtly refusing to do what the event staff says, 3) inflicting harm on another participant, 4) engaging in a behavior that disrupts the event, 5) stealing, or 6) having or using non-prescription drugs, the WVU Extension Service reserves that right to send the participant home at their own cost. OPEN TO ALL: Activities offered by the WVU Extension Service are available to all persons who meet age and membership requirements for WV CEOS membership. Programs and activities offered by the West Virginia University Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, sexual orientation, or national origin. OTHER QUESTIONS: We will be glad to answer any of your questions prior to the event. Feel free to contact any of the individuals below for further information:  Julie Tritz, WVU Wayne County Extension Agent, 304-272-6839 or [email protected]  Tina Cowger, WVU Marion County Extension Agent, 304-367-2772 or [email protected]

Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.

REGISTRATION FORM NAME: _____________________________________________ first

CIRCLE ONE: MALE /FEMALE

last

MAILING ADDRESS: _______________________________________________________________ street

city

state

ZIP

DATE OF BIRTH ____/____/_______ EMAIL ADDRESS: __________________________________ PHONE: (_____)__________________

CELL PHONE: (_____)________________________

SELECT THE ONE THAT APPLIES TO YOU: _____ I am a CEOS member

_____ I am a spouse of a CEOS member

_____ I am a friend of WVUES

_____ I am WVUES faculty/staff member

SELECT ONE AIRPORT FOR YOUR TRAVEL: _____ Pittsburgh International Airport Pittsburgh, PA

_____ Yeager Airport Charleston, WV

--------------------------------------------------------------------------------------------------------------------------------------SPECIAL NEEDS INFORMATION Please provide information on any special needs that must be taken into account for rooming, transportation, or other considerations. Please attach a statement describing special needs. ____ I need to take medications. ____ I have special food restrictions. ____ I need other special accommodations. --------------------------------------------------------------------------------------------------------------------------------------EMERGENCY CONTACT INFORMATION NAME: __________________________________________ RELATIONSHIP TO PARTICIPANT: __________________ PHONE: (_____)__________________

CELL PHONE: (_____)________________________

Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.

PREFERENCE OF COURSES •

Digital Photography – Learn how to get the best from your camera with confidence & understanding. Participants must bring a camera to use in traveling to local villages and destinations.

•

Cookery – From one pot wonders to impressing your friends with a dinner party to die for.

•

Limerick Lace – An embroidered needle lace formed on a mesh using one or both of two techniques – Tambour is created using a hook, or Needlerum.

1st CHOICE: ________________________________________ 2nd CHOICE: ________________________________________ 3rd CHOICE: ________________________________________ ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

ACCOMMODATIONS Rooms are assigned on a first-come, first-serve basis with special accommodations taken into consideration. We will try to accommodate your preference to the best of our ability. _____ I prefer to be in a room by myself.

____ I prefer to have roommates.

Please list your roommate(s) preferences. FIRST NAME

LAST NAME

MALE/FEMALE

COUNTY

Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.

MEDIA RECORDING/USAGE RELEASE WVU EXTENSION SERVICE COUNTY OFFICES I hereby give my consent for the image and likeness of __________________________ to be videotaped, audiotaped, or photographed for the following uses: • • • •

Educational/Instructional media Development media Recruitment/Outreach media Newsworthy media documentation

I further authorize West Virginia University, WVU Extension Service, and/or West Virginia University Hospitals, Inc. and their component parts to use this electronic media and/or photographs in any manner-whole, or in part. This waiver includes usage of this media in any way deemed appropriate, which may include electronic and photographical reproductions thereof for the production educational, instructional, promotional, or institutional advancement materials which support the educational and outreach activities of West Virginia University. I hereby waive any right I may have to inspect or approve any use of this electronic media and/or photographs and I release West Virginia University and its component parts from all liability which could result from its use. __________________________________________________ Participant’s Signature

_____________________________ Date

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CEOS TRIP TO IRELAND POLICIES & RULES Participant Commitment: I understand the WVU Extension Service Policies and Rules and agree to follow these rules while attending the 2017 CEOS Trip to Ireland. _________________________________

___________________________________

Participant’s Printed Name

Participant’s Signature

_________

Date

Programs and activities offered by the West Virginia Cooperative Extension Service are available to all persons without regard to race, color, sex, disability, religion, age, veteran status, political beliefs, sexual orientation, national origin, and marital or family status.