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Participant Form

During a First Descents Program, participants will have the opportunity to partake in various activities. These activities can be strenuous and will occur in the outdoors away from immediate medical care. The risk of participation is increased by certain physical and mental conditions. Thus, it is important to screen every applicant for such conditions.


The purpose of this Participant Form is to provide the First Descents staff with a comprehensive understanding of your current medical condition. Your responses regarding your own medical fitness for participation in the First Descents Program described below (the “Program"), is requested to help the First Descents team provide you with an enjoyable and safe Program.


Please answer the following questions as thoroughly and accurately as possible. If you are not currently experiencing any of the conditions referenced herein, but your medical condition subsequently changes and includes any of the conditions referenced in this Participant Form or in the Participant Form Release Policies, attached hereto, please advise First Descents immediately. It is your responsibility to ensure that the content of this Participant Form is accurate and complete at all times prior to the Program and during the Program.


You must complete and sign this Participant Form in order to participate in the Program. A positive response to a question does not necessarily disqualify you from participating. Rather, the First Descents Medical Review Team will make a determination, based on the information in this Participant Form and the Doctor Form as to whether or not you are approved to participate in the Program.


If you have any additional questions regarding this Participant Form, please review this form with your physician before submitting to First Descents. For additional information regarding First Descents Program policies and procedures, please review the First Descents Policies attached.

Pre Program Health Agreement


First Descents (FD) Participants, Staff, and Volunteers should adhere to FD’s health principles and application requirements in order to attend a program. It is everyone’s personal responsibility to review these guidelines and adhere to them in order to ensure the safety and health of everyone at a program.


Pre-Program General Principles


  • Complete all paperwork in a timely and honest manner. 

  • Inform the Programs Team of any changes to your health condition leading up to a program. 

  • COVID-19 vaccinations are not required at this time to attend a program. However, program control measures must be followed at all times whether you have been vaccinated or not.

  • Arrive at a program healthy. Please do not come if you’re feeling unwell or sick, including showing symptoms of COVID-19 or other illness. Arriving at a program sick, or potentially being contagious, puts others at risk and can spread illness.

  • Eat well and hydrate in advance of the program.

  • Everyone may l be asked to transport themselves in their personal vehicles to and from the program and activity site. If carpooling, masking must be utilized.

  • Fatigue plays a part in both injuries and illnesses and a FD program is a very busy and exciting experience! Be sure to get enough rest leading up to a program so you can enjoy the program and stay healthy and safe. 

  • If you require special accommodations (e.g. gear, dietary restrictions, sleeping needs, allergies, etc.) please inform the Programs Team well in advance of the program start date.

  • Check the weather before you pack and bring what you will need, including clothes and shoes appropriate for outdoor activities, as well as spending time as a group relaxing, and enjoying meals.. FD’s Packing List for your specific program activity will be emailed to you.

  • Please bring at least two (2) face masks and hand sanitizer with you.

  • The CDC encourages anyone who has traveled internationally to stay home, monitor their health and practice social distancing for 14 days after returning from travel. As a result, please do not attend a program within 14 days of international travel.


At-Program Principles

  • Come prepared to complete a COVID-19 screening at the beginning of the program, including a temperature check, and exposure and symptom screening led by FD staff or a volunteer. Everyone must complete the screening to be admitted to the program.

  • Adhere to FD’s program control measures at all times, including: 

    • Hand Hygiene

    • Respiratory Etiquette 

    • Face Covering and Use of Masks

    • Cleaning and Disinfection

    • Social Distancing

    • Follow Transportation Protocol (e.g.use of personal vehicle when appropriate)

  • Please turn your cell phones off and leave them in your cars and/or rooms. Cell phones often collect germs and can spread illness. Additionally, FD programs are technology-free. This is a once-in-a-lifetime opportunity for you to unplug and connect in a meaningful way with yourself and others for a short period of time.

  • Please come alone. Do not bring your family, friends and/or beloved pets unless you have been instructed otherwise by the Programs Team.

  • Do not share personal belongings, including drinks, shared food utensils and containers, hair brushes, pillows, toothbrushes, etc.

  • Do not leave the program at any time. If you leave the program, you will not be readmitted.

  • If you notice a change in your health, please report to a FD Staff member immediately. You may be asked to isolate from the group until your symptoms can be verified.

  • Communicate any questions, concerns, or observations to FD Staff directly.

  • In the event of a suspected communicable disease case, medical advice will be sought and communicable disease prevention protocols implemented.


FD’s Application Process


In light of COVID-19 and in order to keep everyone safe and healthy, FD’s program application process includes:

  1. A general medical application including FD policies, biographical information, medical history, screening for high risk factors as outlined by the CDC, and exposure to COVID-19, etc.

  2. A Physician’s Authorization for individuals with any high-risk factors, as outlined by CDC. 

  3. Follow up emails to screen for illness and exposure to COVID-19.

  4. On-site screening for COVID-19 symptoms, exposure, and a temperature check. This is a CDC recommendation for any outdoor programs and will be conducted for everyone even if they have received the COVID-19 vaccination (the COVID-19 vaccine is not 100% effective).

  5. Additionally, Lead Staff and/or Medical Volunteer will be conducting daily COVID-19 symptom tracking each program day. For overnight programs, the FD team will conduct daily medical observations related to COVID-19 symptoms.

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person. First Descents has put in place preventative measures to reduce the spread of COVID-19; however, First Descents cannot guarantee that you will not become infected with COVID-19. Further, participation in a First Descents program could increase your risk of contracting COVID-19.


All program participants and volunteers will be required to sign First Descents’ Release of Liability and Waiver of Legal Rights ahead of each program in order to be allowed admittance. Note: The public health situation and  pandemic is constantly changing,FD may need to make changes to the application process as new information becomes available. If FD makes changes to the application or requirements you will be notified.


This Registration Form is for the MS Multi-Day Whitewater Kayaking Program, on July 23-25, 2021 in Charlemont, MA.

Completing this registration does not guarantee you a spot on this program. We will leave registration open for a week and will let you know the next steps if you're selected.

First Descents Policies     


VOLUNTEER MEDICAL AUTHORIZATION STATEMENT & CONSENT: 


This Volunteer Application, together with First Descents release policies, are a statement in which you are informed of some potential risks involved in participating in an FD Program and of the conduct required of you before, during, and after a Program. You must complete this Medical Authorization Statement and Consent, which includes the Volunteer Form, in order to be accepted as a FD volunteer.


First Descents requires disclosure of certain medical information for all of its Participants and Volunteers. The purpose of this information will be used strictly to ensure a safe and enjoyable experience for all Program attendees. Because of this, First Descents may disclose medical information provided by its Participants and Volunteers to First Descents Staff, Medical Reviewers, Medical Volunteers, Contract Outfitters, and, in the event of an emergency, local medical facilities and Participant/Volunteer’s Emergency Contacts. Your information will otherwise remain confidential. You may obtain a copy of this authorization for your records if you choose. 


Additional First Descents Volunteer Policies 


First Descents believes in creating a welcoming and safe environment for Participants, Volunteers, Staff, Outfitters and Visitors. All Participants, Staff, Outfitters, Volunteers and Visitors are prohibited from possessing or consuming illicit drugs, recreational marijuana, weapons/contraband, and offensive material (pornography) while at a Program. They are also banned from sharing any prescription medication with others. If Participants and/or Volunteers are prescribed medical marijuana as part of their treatment plan (or for other reasons), First Descents will not prevent the individual from possessing and consuming medically prescribed marijuana. At all times, local and state laws will be applicable and at no time, do FD’s policies supersede local, state, and/or federal laws. At no time under any circumstances will a Participant or Volunteer be allowed to share their medication and/or medical marijuana with another individual. 


Participants are prohibited from possessing or consuming alcohol at any time while at Programs. Staff, Volunteers and Visitors are barred from consuming alcohol in the company of Participants between the start and end date of the day’s planned activities. Light alcoholic consumption is allowed at the Staff and Volunteer Dinner the night before Participants arrive. Staff and Volunteers must exercise discretion and maintain a blood alcohol content (BAC) below the legal limit for driving. While Participants are present, Staff, Volunteers and Visitors may consume light amounts of alcohol at the completion of the day in privacy away from Participants. However, there must be a designated driver (among FD’s approved drivers, including Volunteers) assigned each night, who consumes no alcohol in the event of an emergency. Light alcohol consumption is defined as maintaining a blood alcohol content below the legal driving limit.



Notice to the Volunteer


First Descents Programs encourage self reliance, independence and good judgment throughout the duration of the Program. Consequently, everyone must be expected to administer their own medications without supervision. Additionally, any over-the-counter medications that anyone might require, including Participants, should be brought and self-administered (i.e. pain medications for minor aches such as Tylenol, Ibuprofen and/or allergy medicines).

 


Emergency Medical Care Authorization



APPLICANT'S MEDICAL AUTHORIZATION STATEMENT & CONSENT: 

This PARTICIPANT FORM, together with the FIRST DESCENTS RELEASE POLICIES, are a statement in which you are informed of some potential risks involved in participating in the Program and of the conduct required of you before, during and after the Program. You must complete this Applicant’s Medical Authorization Statement and Consent, which includes the Participant Form section, to be accepted to the Program.


First Descents Programs encourage self reliance, independence and good judgment on/off the river/mountain. Consequently First Descents encourages everyone to be observant and to immediately bring forth any concerns about their own or a Participant’s medical conditions to the staff. Everyone, including Volunteers and Participants, are expected to self-administer their own medications without supervision.


Finally, certain medical conditions can pose additional risk to First Descents Volunteers, Staff, Outfitters and Participants. These include but are not limited to: seizures/syncope, physical disabilities, and the use of anticoagulation medication. Such conditions add an increased but unquantifiable risk to activities during the Program and anyone with those conditions, regardless of role, should discuss those conditions with their personal physician, as well as contact and communicate those conditions and any questions or concerts to First Descents.





Personal Info

Personal and Contact Information 

Emergency Contacts


Please list two emergency contacts that are reliable and available that FD can reach out to to provide support in the event of an emergency.
Emergency Contact #1
Emergency Contact #2

Medical Information

GENERAL MEDICAL 


NEUROLOGICAL
Neurologist, Specialist, or Physician Info
(Whoever you see the most frequently)
Additional Team Info
PSYCHIATRIC
First Descents strives to create a safe place for our participants physically and from a mental health perspective. We understand the stigmas that sometimes exist about some of the questions listed below. This information will only be used by our team to helps us prepare for the best experience possible for you. 
HEMATOLOGY/ONCOLOGY
Oncology Questions
Oncologist, Radiologist, Specialist, Or Family Physician Info
(Whoever you see the most frequently)
Additional Team Info
IMMUNOLOGY AND INFECTIOUS DISEASE
EYE AND EAR
ORTHOPEDIC AND MUSCULOSKELETAL
FUNCTIONAL/ENVIRONMENTAL

SURGICAL
MEDICATION
ALLERGIES

Healthcare Worker Questions
Volunteer

Photo Release

Media Involvement
First Descents Cancellation Policy

At FD, we’ll do everything in our power to make this adventure a reality for you. However, we understand that sometimes life throws curve balls, and you might not be able to attend the program that you’ve committed to. We simply ask that you please notify us immediately if you’re unable to attend, so that we are able to give this amazing opportunity to another participant.

First Descents
3858 Walnut Street | Suite 161 | Denver, CO 80205
www.firstdescents.org | info@firstdescents.org
main: 303.945.2490 | fax: 866.592.6911