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COVID-19 VACCINATION CERTIFICATE
COVID-19 Vaccination Certificate Upload
Email
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Member 1 Name
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First
Last
Club Involvement
*
Volunteer for State Titles 2022
Patrol Captain
Water Safety - Carnivals and Nippers
Competitor - U14 +
Coach/Official
Patrol Member
Trainer/Assesor
Club House Access
GYM Access
Patrol (if relevant)
*
N/A
Patrol 1
Patrol 2
Patrol 3
Patrol 4
Patrol 5
Patrol 6
Patrol 7
Patrol 8
Patrol 9
Patrol 11
Patrol 12
Patrol 13
Patrol 14
Vaccination Status
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Double Vaccinated - Fully Vaxed
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Medical Exemption
Member Document Upload of COVID Vaccination or Medical Exemption
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Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 8 MB.
Please provide COVID-19 Vaccination certificate this will deleted once sighted. Document will not be kept in database.
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