Tour form: Health

Health Form & Release

Required for ALL students traveling with the tour group

(Parents/Guardians/Other Travelers May submit the form if you would like the medical personnel on tour to have access to this information.)

*Submit your form NO LATER THAN March 1, 2021

Please provide a family emergency contact:

Please provide a nonfamily emergency contact:

Medical Conditions: Check All that apply

In case of an accident or serious illness, I understand that YOBC will contact me. If YOBC is unable to reach me, the administrator in charge has my permission to obtain the services of a physician and/or hospital until I can be reached.

I, the undersigned member and/or member's parent or guardian, hereby indemnify and hold harmless YOBC, its officers, directors, tour chaperones, and all other agents against and from any and all claims, damages, injuries, demands, expenses, or losses, direct or indirect, arising out of or related to the rendering or failure to render medical treatment.

 

Student forms require the signature of the student AND parent/guardian.  If you are submitting a form for a parent/guardian, only one signature is required.