Is the player currently taking any form of Medication (e.g. tablets, inhaler)? YES / NO
Is the player prone to headaches, fainting or dizziness? YES / NO
Does the player have any bone (past break or fracture) or joint problems that could be aggravated by physical contact activity? YES / NO
Has the Player suffered from any form of concussion? YES / NO
If you answered YES to one or more of the above questions, a note of approval from your doctor may be required, please contact the Coach or Child Welfare Officer.
If there is any other condition which may affect your player’s participation in any way that is not covered by the above and which the ach should be made aware of please inform coach and manager.
