March of the Living 2022-2023 Application

Medical Form Part B: Medication and Mental Health
To be completed by Parent(s)/Guardian(s)
Medical Form Part A & B due by November 16th. 
Physical Examination Form Upload due by January 2nd.


Your teen is applying to participate in Miami's Leo Martin March of the Living 2022-2023 program. Miami’s March of the Living is an year long identity-building program that uses Poland and Israel as a platform to study the history of the Holocaust and examine the roots of prejudice, intolerance and hatred. Click Here for the program calendar for you to review to ensure your child can participate fully. 

In order for their application to be complete, you, as the selected parent/guardian must complete the medical portion of the application. Part A & B should take you about 10 minutes to complete. We suggest using a computer and not a phone to access the form.

There are three parts of the medical paperwork: 

  1. Medical Form Part A
  2. Medical Form Part B
  3. Physical Examination Form Download and give to physician 
  4. Physical Examination Form Upload the completed form

Please complete all fields to the best of your ability.

*Denotes a required field

Be sure to enter your teen's email address below exactly how it appears in the email you received.


Please note: Participants who take medication on a regular basis will be responsible for that regimen during all travel and meeting times. The medical professional with the group during Miami's Leo Martin March of the Living is not responsible for dispensing medication on a regular basis. March staff members, other than a licensed medical professional, are not permitted to dispense medication of any kind; therefore, the participant must bring and be responsible for all of their own medication. If the participant requires medical attention beyond their regular routines they will see a licensed medical professional.

IMPORTANT NOTE: If your teen is on medication for emotional health issues, it is recommended that s/he be on the same medication / dosage for at least 1 month prior to and during the Israel trip. Please provide additional information below and notify us if there is any change.

I agree
Please print the physical medical examination form by CLICKING HERE
This form must be completed by the teen’s physician or nurse practitioner and returned by January 2, 2023.
Please note that your application will remain incomplete until this form is submitted.
Please scan and upload the document through your portal once it is completed.