Vaccine Verification Form (King Township Minor Hockey)

Print Vaccine Verification Form

As required by the OMHA Vaccine Policy, all associations are required to verify coaches, volunteers and players have received two doses and are fully vaccinated by November 1st. We request you complete the following form and upload a copy as follows: 1. If two doses are complete, only upload the 2nd dose vaccine certificate 2. If only one dose complete, upload the 1st dose vaccine certificate and be sure to upload the 2nd dose as soon as its complete. 3. If you have received an APPROVED OMHA accomodation, please upload that document Be assured documents will be deleted and nothing will be stored after verification is complete. Should you not wish to upload your document, you will be required to make arrangements to provide the receipt in person.

First Name:^*
Last Name:^*
Participant Type:^*
Player
Bench Staff (Coach/Trainer/Manager)
Official
Volunteer/Timekeeper
Vaccine Receipt Type:^*
1st Dose Only2nd Dose

Date of Vaccine on Certificate^*

Open the calendar popup.

Team?^*

Volunteers/Staff use KTMH Association
Attach Vaccine Receipt^*

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