Vaccination Intake Form (Kingston Baseball Association)

Vaccination Intake Form

Click Here To Complete Proof of Vaccination Form

Date of Birth^*

Required

Given Name^*

Required

Last Name^*

Required

Phone Number^*

Required

Example xxx-xxx-xxxx

Email Address^*

Required

Position on Team^*

Required

indicate if you are bench staff, player, board member or umpire

What team are you with^*

Required

Have you completed your second dose?^*

Required

Add your proof of vaccination.^*

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