PROOF OF VACCINATION/EXEMPTION - COACHES/BENCH STAFF/VOLUNTEERS ONLY (Waterloo Minor Hockey)

Print PROOF OF VACCINATION/EXEMPTION - COACHES/BENCH STAFF/VOLUNTEERS ONLY
Please complete the form and upload the applicable documentation, as outlined. THIS FORM IS FOR ROSTERED BENCH STAFF AND VOLUNTEERS ONLY! All documentation uploads will be reviewed and deleted.
Personal Information
Enter information below.
Team Affliliation
What team will you be rostered to this Season or volunteering with?
  1. Choose your team - if you don't know what team you will be with this season, please enter the age group (ie - U15), you will be helping with in the next question.
  2. ie - U15
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.
NOTES
FOR OFFICE USE ONLY
Human Validation
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Printed from waterloominorhockey.com on Tuesday, October 19, 2021 at 11:21 PM