THE INSTITUTE OF ADVANCED WANDERING
Official Subject Intake Form
DATE OF BIRTH:
MINOR DETECTED: GUARDIAN CONSENT REQUIRED
Relationship to Minor...
Parent
Legal Guardian
Other Authorized Adult
Do you have any medical conditions, allergies, or neurodivergence we should know about to keep you safe or make your experience more inclusive?
Only provide info necessary for your safety/inclusion during this event.
I confirm I am physically fit for the activity and have disclosed all relevant safety information.
I understand the nature of the Institute's activities and the potential risks involved.
I consent to the Institute holding this data for safety coordination and insurance purposes, in accordance with the Data Retention Policy.
AUTHORIZE INTAKE