This information is being collected to enable our staff to more effectively respond to potential medical emergencies. Program participants must supply the requested information in order to be able to take part in program activities. All requested information will be used only for protecting the safety of participants and will not be shared with others, except as necessary to protect participants' safety.
1) Each participant is required to fill in this form for safety management purposes and to deal with incident and emergencies efficiently. All information is strictly CONFIDENTIAL and will be only used for the program's safety management purposes.
2) Please use ENGLISH to fill in the enrollment form.
I, the undersigned (referred as the applicant), declare that the information provided is true and complete. The applicant agrees that the personal data of the applicant may be used by APA GROUP (referred as APA) and its staff for administration, programming and emergencies.
The applicant agrees to abide by the rules for taking part in this program, as well as to participate fully and cooperatively with others while on the course. The applicant understands and accepts that if the rules are not observed, the applicant may be dismissed from the course.
The applicant understands that the course involves physical activities. To the best of the applicant's knowledge, there are no medical or other reasons for the applicant not to take part in the course. The applicant is in normal health with no underclared pre-existing medical or psychological conditions, or allergies.
The applicant understands that there are elements of risk involved in some of the activities and that APA will not be liable for any injuries or accidents. The applicant hereby discharges APA and any other individual or organization connected directly or indirectly with the course from any responsibility in the event of injury, death or loss of property incurred during, as consequence of or while traveling to and from the activity.
The applicant understands that if the course is affected by weather or must be changed/postponed for any other reason by APA, the applicant can join another course within 6 months of the originally scheduled date or ask for a refund.
Applicants are advised to have their own personal medical insurance.
I agree that APA will have the right to use my footage/ images/testimonials in its promotional material or any other material relating to the program for marketing purposes.