How To Qualify

You must be willing to socialize with the motorcycle riders that make your vacation possible. If you are afraid of or do not wish to be surrounded by the 1,000 to 2,000 motorcycle riders that are onboard for a full seven days please, Please don’t apply.

Requirements:

• Must have or be able to obtain a passport BOOK 90 days prior to sail date.
• Must currently be a Hemo-Dialysis patient of a minimum of two years to be considered.

• Must be medically able to travel (determined by Dialysis at Sea medical unit and your dialysis doctor).

• Must be recommended by one of our current or past rally passengers OR be a present/past motorcycle rider yourself. We understand if you no longer ride because of your medical condition. A past picture of you on a motorcycle or copy of an old motorcycle registration card with your name on it may be required.

• If you are not, nor have you ever been a motorcycle enthusiast: You must have a friend or relative that currently is and they must provide the same proof as above.

If you meet the above qualifications please fill out the application below and submit. Due to patients changing medical conditions we will only accept applications no earlier than 7 months prior to upcoming cruise sail date. That’s May for the 2017 rally cruise.

The Debbie’s Dialysis Fund will contact you after reviewing all applications submitted from May 1 till July 1.

 

Debbie’s Dialysis Fund
Patient Application

Please click the link below to download our dialysis patient application. After filling out the application please save it to your computer and email it to: info@highseasrally.com

Download the Application

 

** You will be prompted to download Adobe 9.0 if you have a version that is older than 7.0.
If you DO NOT choose to download the new version of Adobe you MUST print the application and mail it to:

Debbie’s Dialysis Fund

21 Hannah Circle, Suit 101,

Waynesboro, Va. 22980.