Participant Registration & Medical History Form

Participant Registration & Medical History Form
Please complete the Participant Registration & Medical History Form below for your upcoming trip with International Field Studies.
Personal Information
Name (As appears on passport)*

First NameLast Name
Preferred first name*
School Name or Forfar group (if you are not traveling with your school, please list which IFS trip you are attending - ie. Gap Year, alumni week, teacher workshop, etc.)*
Your Role*
Type of Group*
Month of Trip*
Email*
example@example.com
Date of birth*

MonthDayYear
Date
Sex (as appears on passport):*

MaleFemale
Preferred gender pronouns:*
Home street address*
City*
State*
Postal/Zip Code*
Country*
Phone Number*

Area CodePhone Number
(FORFAR ONLY) Do you plan on scuba diving while you're at the field station? ** You must already have your certification to dive at Forfar unless training has already been arranged ***

YesNoNot applicable
What is your highest level of dive certification?
How many dives have you logged?
When was the date of your last dive?

MonthDayYear
Date
Do you have dive insurance? If not, it is strongly encouraged by IFS/Forfar, and may be required for certain divers. Please visit this link for more information.

IF UNDER 18 THE FOLLOWING SECTION MUST BE COMPLETED BY YOUR LEGAL PARENT/ GUARDIAN
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.*

YesNo
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.*

YesNo
Date*
Date*

MonthDayYear
Date
By signing below, I certify all information is correct and was completed by me. *

Clear
Thank you for completing our Participant Registration & Medical History form. We hope you enjoy your trip with IFS!
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Personal Information