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Vaccine Upload

PROOF OF VACCINATION

This form is to confirm proof of vaccination for all players and coaching staff 12 years of age and over. For indoor areas of facilities used for organized sports and recreational fitness activities, the requirement by Durham Region Public Health is;

  • that all coaches, teachers, instructors, individuals officiating at organized sports and volunteers to provide proof of being fully vaccinated against COVID-19 or proof of a valid medical exemption.
  • Participants of organized sports and/or recreational fitness activities, that are 12 to 17 years old, to provide proof of vaccination or a valid exemption.

Participants Name
Participants Name
First
Last

Contact Information

Parent / Guardian
Parent / Guardian
First
Last
I confirm that the player / staff that this form is completed for has received both doses of the Covid-19 Vaccination according to Ontario Public Health Regulations
Maximum upload size: 516MB