If required by your trip leader to obtain a physical prior to your trip, please print out this form and have your physician sign and date and resubmit to Big Round World.
The information provided here is a complete and accurate statement of any physical and psychological conditions that may affect my participation on this trip. I realize that failure to disclose such information could result in serious harm to myself and other participants. I agree to inform my trip leader should there be any changes to my health status prior to the start of the trip. I understand the trip may require vigorous activity that is both physically and mentally demanding in isolated areas without medical facilities. I am fully capable of participating on this trip.