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Health Declaration
Please fill out the following form
in order to participate in our activity.
Player's Name
Parent/Guardian name (u18 Only)
Emergency contact phone number
Have you been hospitalized in the last 12 months?
*
No
Yes
Are you suffering from a medical condition, illness, or injury?
*
No
Yes
If you answered yes to any question, please elaborate
Initials
I declare that the info I’ve provided is accurate & complete
Submit
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