SayPro Health and Safety Form for the 5 Days Religious Studies Camp.

The SayPro Health and Safety Form is designed to collect essential medical information and any health-related concerns from participants prior to attending the 5 Days Religious Studies Camp. This form ensures that the SayPro team can provide appropriate care and attention, ensuring the safety and well-being of all participants throughout the camp, both in-person and online.

Below is a detailed breakdown of the SayPro Health and Safety Form:

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Section 1: Participant Information

1. Full Name:
   • First Name: ___________________________
   • Last Name: ___________________________
2. Date of Birth:
   • (DD/MM/YYYY) _____________________
3. Gender:
   • Male
   • Female
   • Non-Binary
   • Prefer not to say
   • Other: ___________________________
4. Emergency Contact Name:
5. Emergency Contact Phone Number:
6. Relationship to Emergency Contact:

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Section 2: Medical History

1. Do you have any ongoing medical conditions?
   • Yes
   • No
   (If yes, please specify below)
2. Are you currently taking any medication?
   • Yes
   • No
   (If yes, please list the medications and dosages)
3. Have you had any major surgeries or medical procedures in the past?
   • Yes
   • No
   (If yes, please provide details)
4. Do you have any chronic conditions such as asthma, diabetes, heart conditions, or any other significant health concerns?
   • Yes
   • No
   (If yes, please specify)

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Section 3: Allergies and Sensitivities

1. Do you have any known allergies (food, environmental, or medication)?
   • Yes
   • No
   (If yes, please specify the allergens)
2. Do you carry an epinephrine auto-injector (EpiPen) or any other emergency medication for your allergies?
   • Yes
   • No
   (If yes, please specify)
3. Do you have any other sensitivities (e.g., to scents, pollen, chemicals)?
   • Yes
   • No
   (If yes, please describe)

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Section 4: Physical and Mental Health Considerations

1. Do you have any physical limitations or injuries that may affect your ability to participate in certain activities (e.g., yoga, hiking, group exercises)?
   • Yes
   • No
   (If yes, please specify)
2. Do you have any mental health conditions that the facilitators should be aware of (e.g., anxiety, depression, PTSD)?
   • Yes
   • No
   (If yes, please describe and provide any accommodations that may help)
3. Do you have any specific requirements for managing stress or emotional needs during the camp?
   • Yes
   • No
   (If yes, please provide details)

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Section 5: Health and Safety Considerations

1. Do you have any dietary restrictions or food preferences that we should be aware of?
   • Yes
   • No
   (If yes, please specify)
2. Do you require any special accommodations (e.g., wheelchair access, quiet space, additional breaks)?
   • Yes
   • No
   (If yes, please describe)
3. Do you have any health concerns that may require immediate attention during the retreat?
   • Yes
   • No
   (If yes, please provide details)

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Section 6: Consent and Acknowledgment

1. Health and Medical Consent
   By signing this form, I give permission for the camp organizers to provide medical treatment in the event of an emergency and agree to provide any medical history that may affect my participation in the activities. I understand that it is my responsibility to inform the facilitators and support staff about my medical needs.
   • Signature: ___________________________
   • Date: ___________________________
2. Liability Waiver
   I acknowledge that participating in physical activities may involve some level of risk, and I accept full responsibility for my own health and safety. I release SayPro, its staff, and volunteers from any liability in the case of injury or illness during the camp.
   • Signature: ___________________________
   • Date: ___________________________
3. Media Consent
   I consent to being photographed, filmed, or recorded during the retreat for promotional purposes and acknowledge that such media may be used by SayPro in social media, promotional material, or websites.
   • Yes
   • No

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Section 7: Additional Health Information

1. Is there any other health-related information that the camp organizers should be aware of?
2. Is there any other specific support or assistance that you require during the retreat?

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Thank You!

Thank you for completing the SayPro Health and Safety Form. This information will help us ensure your safety and well-being throughout the 5 Days Religious Studies Camp. If you have any further questions or concerns, please do not hesitate to contact us.

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This Health and Safety Form ensures that all necessary medical and health-related information is collected and handled appropriately, providing peace of mind for both participants and organizers. By collecting this information ahead of time, the SayPro team can better accommodate participants’ needs, promote a safe environment, and ensure the overall success of the retreat.