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2025 October China Trip Cultural Exchange

International Memory Training Exchange

October 16–22, 2025 | BeiJing & HeBei

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2025 October China Trip Cultural Exchange Program Application

Program Date: October 16–22, 2025 | BeiJing & HeBei

Birthday
Month
Day
Year

(Type "N/A" if not applicable)

Gender
Female
Male
Prefer not to say

(Information for room assignment)

Parent's Information (For Applicant under 18yrs)

Applicant's Experience

Do you have experience in cultural exchange prior to this program?
Yes
No

(e.g., singing, dancing, playing an instrument, painting, public speaking, sports, etc.)

How did you hear about this program? *
Would you consider apply a scholarship? If yes , please go to our scholarship application page to apply.
Yes
No
Would you like to receive updates about the program via email?
Yes
No

**PDF or image format accepted. Valid passport is required to apply for the program.

*PDF or image format accepted.

If you have already applied for a China travel visa, please let us know the expected date of Visa Approval from China Embassy
Month
Day
Year

Emergency Contact

General Health & Medicine History ( For the last 12 months)

1. Had a recent injury ?
Yes
No
2. Had asthma/wheezing/shortness of breath
Yes
No
3. Had a recent illness?
Yes
No
4. Had seizures, fainting or dizziness?
Yes
No
5. Are you allergic to any medication?
Yes
No
6. Are you allergic to any food?
Yes
No
7. Are you allergic to animals?
Yes
No

Mental, Emotional, and Social Health

1. Ever been treated for attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (AD/HD)
Yes
No
2. Ever been treated for emotional or behavioral difficulties or an eating disorder?
Yes
No
3. During the past 12 months, seen a professional to address mental/emotional health concerns?
Yes
No
4. Had a significant life event that continues to affect the applicant's life?
Yes
No

Medical Treatment Authorization


In the event that the applicant becomes injured or falls ill during the trip, please provide your signature below to authorize PCC coordinators/staff, China staff/chaperones, or their designated personnel to arrange and provide necessary medical treatment for the applicant. All associated medical expenses will be the responsibility of the applicant or their family/guardian.


Parent/Guardian Consent (or applicant if 18 years or older):Please sign below to indicate your consent.

If there is no additional information that you need to provide about your health, please write "None." 

Family / Parent Consent Form

Please review the consent form below. If you agree to the terms, sign your full name and date. If the applicant is under 18, a parent or legal guardian must also sign and date this agreement.

Consent and 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 to the terms outlined in the entire application, including the consent form.

Applicant/Participant Signature Date
Month
Day
Year
Parent/Guardian Signature Date
Month
Day
Year

( If applicant/participant under 18 years old )

( If applicant/participant under 18 years old )

PCC EDUCATION SCHOLARSHIP

Apply for PCC Scholarship Today

Address : 1290 24th Ave, San Francisco, CA 94122

Phone: 415-860-8101 / 415-203-0116

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