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Get Hockey Canada Injury Report Form Ontario

C copy of this authorization shall be considered as effective and valid as the original. Signed: (Parent/Guardian if under 18 years of age) Date: HEALTH INSURANCE INFORMATION Signature: THIS MUST BE FILLED OUT IN FULL OR FORM PROCESSING WILL BE DELAYED Occupation: Employed Full-time Employed Part-time Unemployed Full-Time Student Employer (If minor, list parent s employer): 1. Do you have provincial health coverage? Yes No Province: 2. Do you have other.

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