Contacteer ons

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Name*
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Your emergency contact

Name - Emergency Contact*

Blood Type and Sizes (for logistical reasons)

Health Status

1. Do you have hay fever or allergies?*
2. Are you taking any medication?*
3. Have you been hospitalized during the past 2 years?*
4. Do you have any heart problems, either personally or in your immediate family?*
5. Do you have high or low blood pressure?*
6. Do you have joint problems (neck, back, shoulder, knee, ankle...)?*
7. Do you have any other medical conditions or symptoms (diabetes, epilepsy, asthma, fainting, etc.)?*
8. For women: Are you pregnant?*
9. Have you experienced mental health issues during the past 2 years?*
Consent*

Pre Program Information - Bertelsmann PFO - September 2026

Dear participant,

Outward Bound programmes take place both indoors and outdoors, in a variety of weather conditions. They may include activities such as rock climbing, caving, ropes courses, hiking and a wide range of physical and non-physical group assignments. The programmes are designed to match the abilities of the participants. Participation in all activities is voluntary.

In this context, we kindly ask you to complete this form. Your answers allow us to better tailor the programme to your specific physical condition and to support you in respecting any physical or psychological limits. Not answering or incompletely answering these questions limits our ability to take your health situation into account during the programme. We treat this information confidentially.

Thank you in advance!

The Outward Bound team