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SUMMER TRIP 2016 PARTICIPANT HEALTH STATEMENT Please complete and sign this Health Statement form and mail it to FBA along with a copy of the participants' insurance card to: Forever Bloom Alliance,
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To fill out the participant health statement, follow these steps:
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Obtain a copy of the participant health statement form.
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Read the instructions carefully before filling out the form.
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Provide accurate personal information such as name, date of birth, and contact details.
05
Answer all the questions truthfully and provide any necessary details.
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If there are specific sections or questions that you are unsure about, seek clarification from a medical professional or the event organizer.
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Double-check your responses to ensure they are complete and accurate before submitting the form.
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Sign and date the participant health statement to certify that the information provided is true and correct.

Who needs participant health statement?

01
Anyone participating in an event, program, or activity that involves physical exertion or potential health risks may need to fill out a participant health statement.
02
This can include participants of sports competitions, adventure activities, fitness classes, and similar events.
03
The participant health statement helps organizers and medical personnel assess the participant's health status, identify any potential risks, and take necessary precautions to ensure the participant's well-being during the activity.
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Participant health statement is a form that provides information about the health status of an individual participating in a program.
Participants or individuals enrolled in a program are required to file participant health statement.
Participant health statement can be filled out by providing accurate information about the individual's health status, medical history, and any current medical conditions.
The purpose of participant health statement is to assess the health status of individuals participating in a program and to ensure that necessary accommodations or medical care can be provided.
Participant health statement must include information such as medical history, current medical conditions, allergies, medications, and emergency contact information.
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