Education Across Borders does not provide any medical assistance or support on our programs, and the laws of the United States, and of individual U.S. states of the United States and of their local jurisdictions, do not apply to our programs because our programs take place in Latin America. However, if you were to have a medical emergency on our program and were unable to communicate personally, we want to have available relevant information regarding any medical conditions or limitations that you may have. This is a three-part form in which we require medical information from you, the name and phone number of your current physician, and the name of persons to contact in case of an emergency. Although we do not have a duty to provide medical assistance on this program, we also need you to inform us of any health concerns that may require accommodation so that we can determine whether to make any accommodation.
If we have any reason to believe that you have a condition that will endanger your health and safety or the health and safety of others, or that would require us to change the nature of the program experience that we provide, we reserve the right, prior to and during the program, to ask for a doctor's written approval verifying that you are physically and mentally able to participate in the program without endangering your health or safety or the health or safety of others. A copy of this information will be given to your program director, who will keep it confidential unless there is a medical emergency, in which case your director may provide this information to an attending care provider or emergency responder and/or use it to contact the people you list in Part 3 below.
IMPORTANT: Each program participant must complete, sign, and return this form prior to participating in this program.