Huntsman Marine Academy Student Application/Medical Form
* fields are mandatory
(Communication between the Huntsman and course participants will be through email)
EMERGENCY INFORMATION - Confidential
Give the name and contact information of a person who can be reached in an emergency, during the course dates.
MEDICAL INSURANCE
HEALTH INFORMATION
Please give any drug sensitivities, regular medication and other information that might be of significance to a physician or hospital treating you in an emergency situation.
Each applicant student must prepare an essay describing their career aspirations and why this specific course would help them to meet these objectives. Please upload your essay of up to 350 words maximum here.
I consent that the Huntsman Marine Science Centre can photograph, record and use minor’s image for promotional purposes in any media, including print, broadcast or electronic and to use this material in whole or in part, now and in the future, in printed form and display form for the promotion of the Huntsman Marine Science Centre.
I do voluntarily consent to said minor's participation, and I do hereby assume all risks of loss and injury that may be incurred, directly or indirectly as a result to said minor's participation in all activities at the HUNTSMAN MARINE SCIENCE CENTRE. I also authorize the HUNTSMAN MARINE SCIENCE CENTRE to arrange for professional care and treatment in case of medical emergency.
I further agree to direct my son/daughter to comply with Huntsman policies and personnel. I realize that if my son/daughter does not comply with said policies, he/she may be sent home from the facility at my, the parent or legal guardian's, expense.
The HUNTSMAN MARINE SCIENCE CENTRE reserves the right to cancel the program and refund all monies in the event that enrolment is inadequate. Participants are responsible for all travel expenses to St. Andrews and will not be reimbursed for those expenses in the event that the program is cancelled.
(use cursor to sign)
