Please note that it is extremely important that you provide us with complete information about your teen's medical and psychological history. This information is vital to ensure your teen's safety and well-being. Please take the time to complete this form accurately and thoroughly. Omissions can be serious for the individual and can affect the entire group.
All information will be kept strictly confidential by Miami's March of the Living staff and will only be referenced or shared with others to assist in ensuring the physical, psychological, and emotional well-being of your teen.
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.