Risk Management Form

Full Name(Required)
Student Email(Required)
Please list any allergies or accommodations that you require that you may not have included as part of your initial registration to this international field study. E.g. Vegetarian, Vegan, CPAP Machine, Allergic to Penicillin, Physical/Mental Health-related Accommodations Need, Medical Conditions that may impact your participation in activities listed on the itinerary. If you would prefer to speak privately with a Be World Ready team member, please indicate this as your response.
Emergency Contact Name(Required)
e.g. Mother, Father, Friend etc.
The Emergency Contact that I have provided above has been made aware of my travel plans, and is aware that they have been listed as my Emergency Contact:(Required)
I give Be World Ready permission to notify my Emergency Contact in the following scenarios. Please select all that apply. Please note that if you do not provide permission to Be World Ready to notify your Emergency Contact in any of the scenarios listed below, Niagara College may be limited in the ways that we can offer support.(Required)
Max. file size: 12 MB.