OFFICIALS - ON ICE AND OFF ICE VACCINE CONFIRMATION (Waterloo Minor Hockey)

Print OFFICIALS - ON ICE AND OFF ICE VACCINE CONFIRMATION
TO BE COMPLETED BY TIMEKEEPERS AND ON ICE OFFICIALS ONLY!!!
Personal Information
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Role with WMHA Officials
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VACCINE INFORMATION
Please answer the questions below.
Proof of Vaccine or Exemption
Please upload your Dose Receipt or ALLIANCE Approved Exemption Form.
  1. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
    Maximum # Files: 1. Maximum File Size: 4MB.
  2. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
    Maximum # Files: 1. Maximum File Size: 4MB.
    A Dose Administration Receipt from the Government of Ontario or Physician's Official Record are the only 2 acceptable forms of proof.
  3. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
    Maximum # Files: 1. Maximum File Size: 4MB.
    A Dose Administration Receipt from the Government of Ontario or Physician's Official Record are the only 2 acceptable forms of proof.
  4. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
    Maximum # Files: 1. Maximum File Size: 4MB.
    An approved ALLIANCE Exemption Form is the only acceptable proof of exemption.
Confirmation
Please provide your email address to receive confirmation of form submission.
  1. Example: [email protected] Your submission will be sent to this address.
Human Validation
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Printed from waterloominorhockey.com on Saturday, September 18, 2021 at 2:48 AM