Belo USA

Choose your trip(s) *
Select one or more trips that you wish to register for.
East Coast Trip

June 17 to June 30 - $3125.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
Hawaii Expedition 1

January 31 to February 6 - $1645.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
Hawaii Expedition 5

February 28 to March 6 - $2170.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
Hawaii Expedition 6

March 7 to March 13 - $1645.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
Hawaii Expedition 7

March 14 to March 20 - $2170.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
New York Christmas Special 1

December 5 to December 9 - $1410.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
New York City 1

March 27 to March 31 - $1410.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
New York City 4

April 18 to April 22 - $1410.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
New York City/Washington DC 1

March 27 to April 3 - $1925.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
New York City/Washington DC 4

April 18 to April 25 - $1925.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
West Coast Trip 1

June 5 to June 18 - $3145.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
West Coast Trip 2

June 8 to June 21 - $3145.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
West Coast Trip 3

June 11 to June 27 - $3145.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
West Coast Trip 4

June 18 to July 1 - $3145.00
Please choose accommodations:

Standard Accommodation (2 students per bed, 4 to a room) - Included

Single Bed Accommodation (Own bed for an extra fee) - Add $.00
Participant Details
You are: * First Name *Last Name *Nickname (name you like to be called) Country of Origin *Passport Country *Passport Number * Full Name * (Same as Passport)Select Date Passport Issued *Select Date Passport Expires * E-mail Address *Cell Phone No (with Country Code)Select Date of Birth *Gender *What is the full name of your US Rotary Club Youth Exchange Officer (YEO) and your district number? *Please provide the phone number and email address of your US YEO. * InstagramFacebookWhatsApp Exchange Year: *
Host Country Information
First Name of Host Parent #1 *Last Name of Host Parent #1 *Cell Phone No (with Country Code) E-mail Address *First Name of Host Parent #2Last Name of Host Parent #2Cell Phone No (with Country Code) E-mail AddressStreet Address *City *State/Province *Zip/Postal Code *Country *Host Family Home PhoneHost High School Name * Host High School City and State/Province * Select the district or region where you are hosted:*
Home Country Information
First Name of Natural Parent #1 *Last Name of Natural Parent #1 *Cell Phone No (with Country Code) E-mail Address *First Name of Natural Parent #2Last Name of Natural Parent #2Cell Phone No (with Country Code) E-mail AddressStreet Address *City *State/Province *Zip/Postal CodeCountry * Home Phone NoHome School Name *Home School City *Home (Sponsor) Organization *Home (Sponsor) District/Division
Medical Information
Name of Medical Insurance Company *Insurance Policy No. & ID No. *Allergies, if any *Medications, if any *Dietary Restrictions, if any *
General Information

Do you smoke? * Yes NoCan you swim? * Yes NoHave you had swimming lessons? * Yes NoT-shirt Size: * How did you hear about South Central Rotary Youth Exchange Tours with Belo USA Travel? * * I have read and I do agree with all of the terms of this trip's general conditions.
* I agree that my personal information may be used in accordance with our privacy policy.

* This information is required.

Reservation Form

South Central Rotary Youth Exchange

Reservation Information