Vaccination Information 2021 (Mooretown Lady Flags)

Print Vaccination Information 2021
Please fill out all sections & upload either a screen shot or scan of your proof of 2nd COVID vaccine. Your records will be kept confidential and only the Mooretown Lady Flagsrep collecting will have access to them.
Information
  1. RadDatePicker
    RadDatePicker
    Open the calendar popup.
  2. Example: [email protected] Your submission will be sent to this address.
Lady Flags Position
Please use the drop down menu to identify as either a player, executive member or pick the appropriate age group (coach, manager, trainer etc)
1st Vaccine Info
Please enter the date of your first vaccine.
  1. RadDatePicker
    RadDatePicker
    Open the calendar popup.
Proof of 2nd Vaccine
Please upload your proof of 2nd vaccine. This information is kept confidential & not shared with anyone other than the person collecting on behalf of Mooretown Lady Flags.
  1. Allowed extensions: .jpeg, .jpg, .png, .gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
    Maximum # Files: 1. Maximum File Size: 4MB.
Human Validation
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Printed from mooretownladyflags.ca on Tuesday, November 30, 2021 at 1:14 PM