Birthright Rite of Passage Pre Registration

Please read carefully before completing the registration.

*DISCLAIMER PAGE

This form should be completed by the applicant only. So parents, let your children take responsibility and the steps personally to make this happen! Thanks!

Once we receive your application/registration, it will take approximately three (3) months to communicate your acceptance in the program. Once accepted, you will have another 3-6 months to prepare for the journey. The preparation is just as important as the passage and journey itself.

It is our intention to make this opportunity available for EVERY person 18-25 years old of African Ancestry to have the Birthright experience without question. It’s not a handout, it’s your Birthright!

Candidates will be selected randomly on a first come first serve basis by our selection committee.

In summary, please complete this form ONLY if you meet these requirements:

I am between the ages of 18-25 years old during 2022-2023 calendar year.
I am of Indigenous/native/melanated ancestry, or have African ancestors or consider yourself black/or descendants of enslaved Africans.
I am growth orientated, and have a thirst for discovering more about myself and my ancestral past.
I am OK travelling to Africa for 10-12 days.
I am Ok and willing to participate in transformative experiences.

You will be required to submit a brief summary of why you would like to go on the Exploring Legacy™ Rite of Passage.

Name(Required)

First Last

Mobile Phone Number(Required)

Email(Required)

Date of Birth

Location /Zones(Required)

Zone 1 - The Caribbean (Jamaica, Haiti, T&T, etc.)

Zone 2 - The Americas (North & South America - USA, Canada, Costa Rica, etc.)

Zone 3 - Europe (Including the U.K)

Zone 4 - Asia

Zone 5 - Australia & Oceana (New Guinea, Fiji, New Zealand, etc.)

More About You…

Have you visited Africa before?

Yes

Do You Currently Have A Valid Passport?(Required)

From Which Country?

What Is Your Birth Country?

Gender As Appears On Your Passport?

Male

Female

EMERGENCY CONTACT

Who can we contact in case of an emergency

Name(Required)

First Last

Phone number(Required)

Email Address(Required)

Relationship

More About Me

Education(Required)

High school or Less

Associates

Bachelors

Masters or higher

Are you currently a student ?

Yes

Ancestry & Background Questions

Is Your Mother, Father Or Grandparents Of Direct African Descent?

Yes

Do You Consider Yourself A Descendant of Enslaved Africans or A Descendant of A Melanated Indigenous Native (Taino, etc.)

Yes

Tell us a bit about yourself and why you want to participate in an Exploring Legacy™ Birthright Journey(Required)

200 WORDS MAX

TRAVEL PRREFERENCES

Would you like to travel with your friends?

Yes

Who would you like to travel with? Please enter up to 10 email addresses...

Enter up to 10 of your travel companion email. We will check to see if they have already signed up.

PLEASE UPLOAD A RECENT PICTURE OF YOURSELF. HEADSHOT , NO SUNGLASSES OR HATS PLEASE

Max. file size: 32 MB.

COVID-19

Covid Vaccination Information

Have you ever tested positive for Covid-19?(Required)

Yes

Please share your COVID-19 vaccination status:(Required)

I am already fully vaccinated

I am in the process of being fully vaccinated

I do not know when I will be fully vaccinated yet

I do not intend to be vaccinated

*Disclaimer:

By giving your consent, you allow Exploring Legacy™ Foundation to collect, store and process personal data (contact details, social media accounts, religious background, payment details etc.) in order to receive our services and keep you informed. We might share your information with third parties who have enabled us to provide this trip, as well as with third parties for the purposes of traveling, accommodation and for programmatic needs. You can find out more about our commitments to the protection of your personal data by consulting our Privacy Policy. Please note that we will be able to provide you with our services only once you have indicated your consent. If you do not grant consent, we will not be able to use your personal data. You may withdraw your consent for the above-mentioned purposes at any time by contacting the Foundation at support@ExploringLegacy.com. All processing of your personal data will cease once you have withdrawn consent, other than where this is required by law or our operational needs, but this will not affect any personal data that has already been processed prior to this point. By providing your details you agree to our Privacy Policy.

Waiver

In order to submit the first section of your application, you must accept the terms and conditions of this waiver. The terms and conditions of the waiver are legally binding on you. Note that it is illegal for anyone other than the individual whose name is on this registration form to accept the terms and conditions of the waiver.

This field is for validation purposes and should be left unchanged.

Exploring Legacy™ Birthright & Rite Of Passage Pre-Registration