SayPro Templates to Use: Medical and Registration Form Template.

SayPro Templates to Use: Medical and Registration Form Template

The Medical and Registration Form Template for the SayPro 5-Day Diving Camp is an essential document that ensures participants are medically fit to engage in scuba diving activities while also collecting their personal information for logistical purposes. This form serves to address both safety and legal aspects, allowing SayPro to provide a safe and well-informed diving experience.

The medical section of the form will help instructors and safety personnel identify any medical conditions or concerns that may affect the participant’s ability to dive safely. The registration section will gather essential contact details, dive preferences, and any required emergency contacts. Consent forms will also be included to ensure participants understand the risks and agree to follow safety protocols.

Below is the detailed breakdown of each section included in the Medical and Registration Form Template:

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1. Personal Information

This section collects basic information to identify the participant and to communicate with them as needed.

• Full Name: _______________________________
• Gender: [ ] Male [ ] Female [ ] Other
• Date of Birth: _______________________________
• Nationality: _______________________________
• Home Address: _______________________________
• City: _______________________________
• State/Province: _______________________________
• Country: _______________________________
• Phone Number: _______________________________
• Email Address: _______________________________
• Emergency Contact Name: _______________________________
• Emergency Contact Phone Number: _______________________________

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2. Medical History

This section helps assess the participant’s fitness to dive, considering any medical conditions or medications that might affect their health and safety during diving activities.

• Have you ever experienced any of the following? (Check all that apply)
  • Asthma
  • Heart conditions (e.g., high blood pressure, heart disease, arrhythmia)
  • Diabetes
  • Seizures or epilepsy
  • Lung disease or disorders (e.g., COPD, emphysema, pneumonia)
  • Recent surgeries or hospitalizations
  • Ear or sinus problems
  • Panic attacks, anxiety, or other psychological conditions
  • Any other serious illness or medical condition not listed here: ____________________
• Do you currently take any prescription or over-the-counter medications?
  • Yes
  • No
  • If yes, please list the medications: _____________________________________________________
• Do you have any allergies (including to medications, foods, etc.)?
  • Yes
  • No
  • If yes, please provide details: _______________________________________________________
• Have you had any injuries that could affect your ability to dive?
  • Yes
  • No
  • If yes, please provide details: _______________________________________________________
• Do you have any physical limitations (e.g., mobility issues, breathing difficulties, etc.) that may impact your diving ability?
  • Yes
  • No
  • If yes, please provide details: _______________________________________________________

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3. Diving Experience

This section collects information about the participant’s prior experience with diving and any specific preferences they may have regarding the dive sessions.

• Have you ever scuba dived before?
  • Yes
  • No
• If yes, how many dives have you completed?
  • ______________________ (Number of dives)
• What level of certification do you hold, if any?
  • PADI Open Water Diver
  • PADI Advanced Open Water Diver
  • Other Certification (Please specify): ___________________
• Do you have any preferences regarding your dive buddy or group (e.g., beginners group, specific instructors)?
  • Yes
  • No
  • If yes, please provide details: _______________________________________________________

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4. Consent and Waivers

This section includes the legal consent required to ensure the safety of the participants and confirm their agreement to adhere to the program’s rules.

• Consent to Participate
  I, the undersigned, hereby confirm that the information provided in this medical form is accurate and complete to the best of my knowledge. I understand that scuba diving is an activity that may involve risks, and I accept full responsibility for participating in the SayPro 5-Day Diving Camp. I will follow all instructions given by the instructors, and I will abide by all safety protocols and guidelines.
  • Participant’s Signature: _________________________
  • Date: ___________________
• Medical Waiver
  I, the undersigned, acknowledge and agree that, in the event of an emergency, the SayPro team may provide medical care and assistance, including arranging transport to a medical facility, if necessary. I consent to the treatment of injuries or health issues during my participation in the camp.
  • Participant’s Signature: _________________________
  • Date: ___________________
• Liability Waiver
  I, the undersigned, understand that scuba diving and related activities involve certain inherent risks, including but not limited to decompression sickness, injury from diving equipment, and accidents. I hereby release SayPro, its employees, contractors, and partners from any liability related to injury, loss, or damage during the camp.
  • Participant’s Signature: _________________________
  • Date: ___________________
• Media Consent (Optional)
  I consent to the use of photographs and videos taken during the camp for promotional purposes, including online materials and social media.
  • Yes
  • No
  • Participant’s Signature: _________________________
  • Date: ___________________

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5. Additional Information

This section provides a space for any other relevant information that could be important for the safety or experience of the participant.

• Is there any other information that the instructors should be aware of regarding your health or personal preferences for diving?
  • Yes
  • No
  • If yes, please provide details: _______________________________________________________
• Do you require any special accommodations during the camp (e.g., dietary restrictions, mobility assistance)?
  • Yes
  • No
  • If yes, please provide details: _______________________________________________________

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6. Final Instructions

This section may include any final instructions for participants regarding their participation in the camp, payment information (if applicable), and where to submit the completed form.

• Form Submission Deadline: __________________________
• Submit completed forms to: __________________________
• Camp Contact Information: __________________________
• Payment Instructions (if applicable): __________________________

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Conclusion

The Medical and Registration Form Template serves as a vital document for ensuring the safety and preparedness of participants in the SayPro 5-Day Diving Camp. It helps gather critical personal, medical, and diving-related information, enabling instructors and camp staff to make informed decisions, tailor the camp experience to individual needs, and adhere to safety standards. The inclusion of liability waivers and consent forms ensures that participants acknowledge the inherent risks of scuba diving while providing SayPro with the necessary legal protections.