MEDICAL FORM



MEDICAL FORM



football clubs for kids

PLEASE FILL OUT THE MEDICAL FORM FOR YOUR CHILD BELOW


If yes, please provide details
Please state if your child has any allergies (Please include food, medication, and/or bee/insect stings)
Does your child have an Epi-pen?
Does your child require as asthma pump?
Is there any reason why your child cannot participate fully in the activities?
Has your child been exposed to any infectious disease within the last 3 weeks? If yes, please state which disease and when exposed:
Does your child have a statement of special education needs or require more supervision than expected of their peer group?