FMSP Registration &Medical History

FMSP Registration &Medical History

Please be sure to complete all pages of this form below for your upcoming classes with International Field Studies. Allow up to 20 minutes to complete.
Personal Information
First Name*
Last Name*
Preferred Name*
Program Start Date:*
Session*
Home Street Address*
City*
State (if not applicable, enter "NA")*
Postal/ Zip Code (if not applicable enter "00000")*
Country*
E-mail*
example@example.com
Phone Number *
Date of birth:
Gender*
Sex (as appears on passport):*

MaleFemale
Preferred gender pronouns *

Additional Information
What is your highest level of dive certification? (Not required - list N/A if you don't have a certification. *
How many dives have you logged?
When was the date of your last dive?
Do you have paddling (kayaking, SUP, or canoeing) experience? If so, please explain.
Do you have an American Canoeing Association (ACA) membership?

YesNo
If so, please list your ACA account #:
Have you ever visited Forfar Field Station? If so, in what capacity. *
Where did you receive your high school degree or GED?*
Have you attended or graduated college? If so, please list where, how many years, and if you graduated.
Do you want to receive more information on the learning accommodations available to students at Forfar?*

Yes, please email me more information.No, not applicable.
Emergency Contact Information
Emergency Contact Name*
First and Last Name
Relationship*
Emergency Contact Phone Number
Emergency Contact Phone Number*
Doctor's name*
Doctor's phone number*
Doctor's phone number

Area CodePhone Number

Flight Information
If the IFS office has contacted you with the go-ahead to purhcase your plane tickets, please include the information below. If not, skip this section and be sure to email us (office@intlfieldstudies.org) once you have your itinerary.
Arrival Flight Time

:HourMinutesAM/PM Option
Arrival Flight Number
Arrival Flight Airline
Arrival Flight Date

MonthDayYear
Date
Departure Flight Time

:HourMinutesAM/PM Option
Departure Flight Number
Departure Flight Airline
Departure Flight Date

MonthDayYear
Date
Please upload a photo of your passport*

Browse Files

Cancelof

International Field Studies, Inc. and Forfar Field Station Drug and Alcohol Policy Agreement
Alcohol is not permited on Forfar Field Station property. I agree to not be intoxicated or have possession of alcohol while on Forfar Field Station property at any time during my stay.

I will not use any illegal, non-prescription drugs while on Andros. Being caught with drugs by local authorities can result in serious charges (fines up to $3,000 that if not paid immediately will result in imprisonment).

I understand that any infraction of this agreement will result in my immediate dismissal from the Forfar Marine Science Program. I will be responsible for all associated costs, including all travel expenses and arrangements to return home. I also understand that I will get no refund for program fees.
Printed name*
Signature*
Date*

MonthDayYear
Date

Handbook & Personal Responsibility Agreement
I will remove all trash from my cabin and I will not leave open and unattended food in my cabin. I will not vandalize or deface any IFS/Forfar property during my stay. I understand that smoking is only permitted in designated areas, if I choose to smoke. Tampering with smoke detectors is prohibited. I will keep my belongings orderly and be respectful to any cabin mates and their property in my cabin. I understand I will be responsible for IFS/Forfar property damage and/or lost or broken equipment under my care.

I have received and read the FMSP Handbook. I agree to all that is stated within said document.
Printed name*
Signature*
Date*

MonthDayYear
Date

Consent
INDIVIDUAL PHOTOGRAPHY AND VIDEOGRAPHY CONSENT: I consent to the taking and use of any photographs, video and/or recorded interview of myself/child during the program for advertising, promotion, publicity and any other lawful purpose by International Field Studies, Inc. now and in the future, whether that use be known or unknown to me, for the purpose of illustration or publication in any form. I waive any right to inspect or approve the photographs or electronic matter and waive any right to royalties or other compensation arising from or related to the use of this media.*

I consentI do not consent
OPT-IN TO INTERNATIONAL FIELD STUDIES, INC. EMAIL LIST: I would like to receive emails from International Field Studies, Inc. Emails may include future Alumni event news, a monthly newsletter, and IFS events. I understand that I may opt out of receiving emails at any time.*

I consentI do not consent

Signature
Thank you for completing our Forfar Marine Science Program Registration & Medical History form! Please complete all other forms as soon as possible. Remember to email our office (office@intlfieldstudies.org) with your flight information. We hope you enjoy your stay at Forfar!
By signing below, I certify this form was completed by me and all information is correct.*
Should be Empty:

Personal Information