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As a Run Club affiliated with Athletic Ontario we are required to obtain a Medical Profile of each of our athletes. The information provided in this form will be kept private and will only be shared with the coaches and used in the case of an unexpected emergency.At the very least we require an emergency contact name and number. Holding back relevant information may delay emergency services providing you with appropriate treatment.
Athlete Name
I identify as

Emergency Contact Details

Medical History

Past Medical History

Please check if you have had any of the following: