Proof of Vaccination (Brantford Minor Hockey Association)

Print Proof of Vaccination
Please upload proof of participants vaccination.
  1. First and last
  2. RadDatePicker
    RadDatePicker
    Open the calendar popup.
  3. Example: you@yourdomain.com. Your submission will be sent to this address.
  4. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx.
    Maximum # Files: 1. Maximum File Size: 4MB.
  5. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx.
    Maximum # Files: 1. Maximum File Size: 4MB.
    If you have not yet received your second dose, please submit the receipt for your first dose and provide the date scheduled for your second dose. Once complete, the form can be resubmitted with both doses”
  6. Please enter date if participant has not yet had a second dose.
Human Validation
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Printed from brantfordminorhockey.com on Saturday, October 23, 2021 at 10:56 PM