Player Vaccine Receipt Submission (Woodstock Wildcats)

Player Vaccine Receipt Submission

Each participant / staff / volunteer must present to the WGHA evidence demonstrating that they have received the completed series of an accepted COVID19 vaccine by October 17, 2021 or earlier. Please use this form to upload your proof of vaccination documentation.

Acceptable documents serving as evidence that an individual is fully vaccinated:
• A digital or physical dose administration receipt
• Medical records signed by a licensed health care provider on that provider’s letterhead indicating vaccine name and date(s) of administration
• Government verification/language (e.g., Government issued vaccine passport, certificate, card, or electronic record).

You can obtain an online copy of your vaccine receipt by clicking the link below and filling out the form
Ontario COVID-19 Portal

I agree to the terms and conditions stated above^*

Proof of Vaccination

Participant's First Name^*

Required

Participant's Last Name^*

Required

Participant's Team^*

Required

Parent / Guardian Full Name^*

Required

Parent/Guardian Phone Number^*

Required

Parent/Guardian Email Address^*

Required

Date of 1st dose:^*

Required

Vaccine Receipt for 1st Dose^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 1. Maximum File Size: 4MB.

Date of 2nd dose:^*

Required

Vaccine Receipt for 2nd Dose^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 1. Maximum File Size: 4MB.

Player Vaccine Receipt Submission (Woodstock Wildcats)

Proof of Vaccination

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