By signing below I hereby certify that the information contained in this form is true, correct, and complete to the best of my knowledge and belief. I understand that any false information, misrepresentation, or omission of facts in this form are grounds for loss of benefits (including without limitation, medical benefits, sick pay, maintenance, death benefits, and disability benefits), disqualification from further consideration, and/or immediate termination of employment without recourse.

I understand the purpose of this examination is for Royal Caribbean Group and/or its affiliates. To obtain information that may be used to determine fitness for duty and/or To comply with legal or other reporting obligations, and/or To investigate or evaluate any alleged or reported injury, loss, damage, crime and its or their causes or circumstances, and/or To assert or defend against legal claims. To achieve the above purposes, I hereby request and authorize Royal Caribbean Group to release all my medical records and information from any source, including without limitation, hospitals, clinics, labs, physicians, psychologists, employers, insurance companies, government authorities, and any other health professionals, health institutions, or public authorities (collectively, "Medical Records') to any Royal Caribbean Group medical personnel, any third party performing medical record review, quality control entities, and any other person or entity necessary for Royal Caribbean Group to determine or verify whether I am fit for duty. In the event I make a claim for medical benefits, sick pay, death, or disability benefits, or any other benefits, I further authorize Royal Caribbean Group to release all my Medical Records to Royal Caribbean Group personnel to make a claim determination or resolve a claim dispute or appeal. I authorize the release of all my Medical Records to the physician(s) performing the medical examination subject of this form. I authorize release of my Medical Records to any government authority such as the F.B.I. the U.S. Coast Guard, the Centers for Disease Control (CDC) or any other national, state or local authority either in the U.S. or abroad, or any other person or entity as may be required by law. I hereby authorize the release of my Medical Records, including patient history, office notes, test results, radiology studies, films, referrals, consultants and billing records, even if said record(s) include information related to alcohol, drug abuse, mental health treatment, or confidential HIV related information, to me and/or my health insurer or any other entity from which I requested third party payment for the services provided at this medical facility. Further, I acknowledge that my Medical Data might be transferred to countries outside the European Union (EU) and/or the European Economic Area (EEA When we transfer your Medical Data outside the EU/EEA, the laws and rules that protect your Medical Data in such countries may be different (or less protective) from your own country. For example, the circumstances in which law enforcement can access your Medical Data may vary from country to country. Your consent declaration is completely voluntary and you may as well revoke it at any time. The withholding or revocation of your consent will not have any negative, especially no disciplinary, consequences. However, Royal Caribbean Group might not be able to assign you to certain tasks that require an approved level of fitness if you withhold or withdraw your consent. If you revoke your consent, this will not impact the legitimacy of the previous use of your data that was based on your initial declaration of consent. You may revoke your consent by email to privacy@rccl.com. If there is another legal basis for processing, Royal Caribbean Group reserves the right to process the data on such other legal basis. This authorization is executed in compliance with the Heath and Insurance Portability and Accountability Act (HIPAA) of 1996 and 45 C.F.R. Parts 160 and 164. You can find all further information on the processing of your Personal Data including your rights to access, rectification and erasure of your data, and contact details for a revocation of your consent in the most recent version of our employee privacy notice available at: http://www.royalcaribbean.com/privacypolicy.

The MLC, 2006 provides that seafarers that have been refused a medical certificate or have had a limitation imposed on their ability to work be given the opportunity to have a further examination by another independent medical practitioner or by an independent medical referee designated by the company. For more information how to file an appeal please contact PEMEREMEREVIEW@rccl.com

EMPLOYMENT BENEFITS AND/OR MAINTENANCE OR CURE BENEFITS. I ALSO AUTHORIZE RELEASE OF ANY / ALL MEDICAL INFORMATION CONCERNING MY PAST, PRESENT OR FUTURE MEDICAL CONDITION(S), BY ANY MEDICAL PRACTITIONER OR PROVIDER, TO ROYAL CARIBBEAN GROUP OR ITS AUTHORIZED REPRESENTATIVE. I AM ABLE TO READ, WRITE AND SPEAK ENGLISH AND FULLY UNDERSTAND ALL OF THE ABOVE INFORMATION.

My signature below signifies that, to the best of my knowledge and belief, all information, answers and responses provided to the company, or company affiliated physicians, labs or medical staff, are true and correct. I fully understand that I have an ongoing obligation to fully disclose any and all medical conditions which may affect my employment, whether listed above or not. I also agree to continuously update Royal Caribbean Group or its affiliated brands with any and all medical information which arise subsequent to the date of this document. I fully understand that if I falsify or withhold relevant medical information or condition(s) and/or fail to provide Royal Caribbean Group or affiliated brands with updated information as necessary subsequent to the date of this document, such action or inaction WILL SERVE AS GROUNDS FOR TERMINATION OF MY EMPLOYMENT WITHOUT

If you require further guidance, please call +44 (0)20 4617 6186 or email us on yehs@yourexcellenthealth.org