Forge 2019 Application Part 2: Logistical

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Personal Information

Please note that you must fill out 3 parts of the application. Please have your passport on hand to complete this section.
 
 
Address Information

 
 
 
 
 
 
Other Details

 
 
 
 
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Please select all that apply.
 
 
 
 
 
 
 
 
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Passport Information:

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Please select one option.
 
 
 
 
 
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Please select one option.
 
 
 
 
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Please select one option.
 
 
Financial Information

 
 
 
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Acknowledgement of Financial Liability

I understand that payment of the required school tuition fees must be made in SA currency prior to or upon arrival, unless
otherwise approved in writing by the Program Director before my arrival in Cape Town. Further, I agree to meet in a timely
manner, prior to the completion of the program, all personal expenses incurred during my involvement with FORGE.
 
 
Release of Liability

I/We do hereby release All Nations and FORGE, its staff, agents and volunteer assistants from any and all liability whatsoever
arising out of any injury, damage, or loss which may be sustained by said person(s) during the course of their involvement with FORGE.
 
 
Emergency Information

 
 
 
 
Consent for Treatment

In case of emergency, I/we hereby agree to the performance of such treatment, including anesthesia and surgery, as the
attending doctor or physician may deem necessary.
 
 
Skill Sheet:

 
 
 
 
 
 
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Please select all that apply.
 
 
 
 

Description

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