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Ghana Journey Registration
Step
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13
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Personal Information
First Name
Last Name
Phone Number
(Required)
Email Address
(Required)
More About You…
Have you visited Ghana before?
Yes
No
MORE ABOUT YOU…
PLEASE UPLOAD A RECENT PICTURE OF YOURSELF. HEADSHOT , NO SUNGLASSES OR HATS PLEASE
File
Max. file size: 32 MB.
Activity Preferences
Please check all activity preferences that apply We integrate a variety of activities, but do you have any special interests?
Ancestry Connection / Ancestral Healing
Exploration of Ancient Wisdom & Modern Integration
Art Galleries & Museums
Beach & Ocean Activities
Clubbing/Nightlife
Gastronomy (Food-centric)
Hiking & Outdoor Activities
Shopping
*Any other preferences?
We would love to learn more about you!
The more you share, the better we can customize the experience…
Please tell us more about yourself and why are you visiting Ghana?
Envision/Imagine it’s day 10 and you are at the end of the trip, what would you like to take away from the experience? What would you have experienced? What’s your takeaway?
Travel Documents - Passport & Visa
Do You Currently Have A Valid Passport?
Yes
No
From what country?
What is your gender as appears on your passport?
What is your passport number?
What is your passport expiration date? (*Note, passports should not expire within 6 months of travel)
Please attached a clear photo of the information page of your passport
Max. file size: 32 MB.
Do you currently have a valid Ghanaian Visa?
Yes
No
what is your visa number?
Please attached a clear photo of the Ghanaian information page of your passport
Max. file size: 32 MB.
EMERGENCY CONTACT
Who do we contact in case of an emergency?
First Name
Last Name
Phone Number
Email Address
Relationship
Parent
Spouse
Friend
Guardian
Ancestry Questionnaire
Would you like to participate in the African Ancestry DNA testing?
Yes
No
what address should we mail your testing kit to?
Do you consider yourself African American?
Yes
No
As a part of the journey here, would you like to participate in a traditional Akan naming ceremony?
Yes
No
What is your date of birth?
Medical Questionnaire
Please note that by submitting medical information via this form, Exploring Legacy™ Foundation shall be permitted to collect, store, your medical information in accordance with the provisions noted in the Privacy Policy, which you have agreed to earlier in the application process.
Do you have any allergies?
Yes
No
Please explain more about your allergies
Do you have any accessibility requirements or physical limitations/restrictions that we need to accommodate while you're in Ghana?
Yes
No
What accessible limitations do you have?
How can we best accommodate for you?
In the past 2 years have you suffered from or been diagnosed with any of the following?
NONE
Anxiety & Depression
Asthma
Blood clothing problems/bleeding
Diabetes
Eating Disorder
Heart Condition
Hospitalization for Surgery
Seizures, fainting, loss of consciousness
Serious illness
Other mental health issues
Other reasons
Please describe the Other Reason.
Are you currently taking any prescription medications?
Yes
No
what medication are you currently taking?
COVID-19
Covid 19 Vaccination Information
Have you ever tested positive for Covid-19?
Yes
No
Please share your COVID-19 vaccination status:
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
ACCOMMODATION ASSIGNMENTS
Our intention is to assign rooms equitably and fairly I would prefer to room with someone of the same sex I am OK rooming with someone of the opposite sex I have elected single occupancy with the NAACP
What kind of a relationship do you want in a roommate?
Do everything together
To be friends
To be respectful and peacefully coexist
Which statement best describes you?
I am a morning person and prefer to live with a morning person.
I am a morning person and can live with a night person.
I am a night person and prefer to live with a night person.
I am a night person but can live with a morning person.
How would you describe your sleeping habits?
Light sleeper
Moderate sleeper
Heavy sleeper
Which statement best describes your standards for the condition of your room?
I like my room to be clean almost always.
I like my room to be generally neat, but I am willing to put up with a little clutter from time to time.
It does not bother me if my room is cluttered and disorganized.
Which statement best describes your standards for the condition of your room?
I like my room to be clean almost always.
I like my room to be generally neat, but I am willing to put up with a little clutter from time to time.
It does not bother me if my room is cluttered and disorganized.
In dealing with conflicts:
I am able to clearly express my feelings and concerns.
I will generally express my concerns in a joking fashion so that the other person gets the hint.
I usually wait until I am really annoyed or angry.
I am not comfortable asserting myself in conflict.
Apparel & Fitting
We may providing complimentary shirts, hats and other wearables…
What is preferable T-Shirt size ?
Small
Medium
Large
X-Large
XX – Large
XXX – Large
*Disclaimer:
By giving your consent, you allow Exploring Legacy™ & The Adinkra Group 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 us 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.
