Illness & Coronavirus report form
We are using this form to try to stay up to date with any illnesses that our club may be encountering
Individual Name(First & Last Name) *
Player/Family Member? *
Team Associated to *
Type of illness *
Additional Symptoms
Have you been checked by a doctor? *
Have you been tested for Coronavirus? *
What date did the symptoms start? *
MM
/
DD
/
YYYY
Have you been exposed to others since feeling sick? *
Submit
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