March of the Living 2024-2025 Application

Medical Form Part A: Examination Form Upload
To be completed by Parent(s)/Guardian(s)
Physical Examination Form Upload due by
September 20, 2024.
Medical Form Part B & C due by
September 20, 2024. 

    
     
   

Your teen is applying to participate in Miami's Leo Martin March of the Living 2023-2024 program. Miami’s March of the Living is a 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 B & C 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 - Physical Examination Form Download and give to physician and Upload the completed form
  2. Medical Form Part B
  3. Medical Form Part C

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

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 September 21, 2023.
 
Please note that your application will remain incomplete until this form is submitted.
 
Please scan and upload the document below once it is completed.

Before uploading your Medical Form Part A, please rename the file with your teen's full name.
Example: john_smith_medforma.jpg


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