Confidential Health Questionnaire

September 5-9, 2018

Frost Valley YMCA - Claryville, NY

If you receive an acceptance letter for the MROP or FIRMING, please name a person as your emergency contact and answer the medical questions. Please note that this information will be kept confidential and is necessary to help ensure the health and safety of all men participating in the MROP. If you have an comments or concerns, do not hesitate to contact us.

(Please answer all questions)