ADTR - Additional Dependent Ticket Request 2024

Honda Associate Name(Required)

First Last

Associate Number(Required)

I confirm I am a Honda Associate:(Required)

YES!

NO

Honda Company(Required)

HDMA

AHM

HTA

List the Plant or Onsite Office Location where you work(Required)

Phone(Required)

Email(Required)

Enter Email Confirm Email

Event:(Required)

Ohio/Indiana - Kings Island

Georgia/Alabama - Six Flags

N./S. Carolinas - Carrowinds

Check below for your reason for using the dependent(s) request form:(Required)

Honda eligible dependents are determined by eligibility for Honda benefits.

STEP CHILDREN OR FOSTER CHILD(REN) (AGE 25 and younger)

FOREIGN EXCHANGE STUDENT

EXTENDED FAMILY YOU HAVE LEGAL CUSTODY OF (AGE 25 AND YOUNGER)

EXPATRIATE/ASSOCIATE ON ASSIGNMENT WHOSE SPOUSE AND/OR DEPENDENT(S) WILL BE ATTENDING WITHOUT THE ASSOCIATE

ELIGIBLE DEPENDENT(S) COVERED OUTSIDE OF HONDA’S BENEFIT COVERAGE 

List the total number of tickets you will need to purchase.(Required)

Please count your free ticket, all the dependent tickets + the additional dependent tickets you are requesting.

1.) NAME + AGE + RELATION TO YOU OF PERSON YOU ARE REQUESTING A TICKET FOR

2.) NAME + AGE + RELATION TO YOU OF PERSON YOU ARE REQUESTING A TICKET FOR

3.) NAME + AGE + RELATION TO YOU OF PERSON YOU ARE REQUESTING A TICKET FOR

4.) NAME + AGE + RELATION TO YOU OF PERSON YOU ARE REQUESTING A TICKET FOR

5.)NAME + AGE + RELATION TO YOU OF PERSON YOU ARE REQUESTING A TICKET FOR

Additional information we may need + reason for completing this form:(Required)