Covid-19 Reporting Form: Aztec Soccer Club

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We want to keep all players, parents, staff and officials safe. Should you have been diagnosed with Covid-19 please submit this form to notify the Aztec Soccer Club.

Your information will remain confidential. Any questions can be directed to our COVID-19 Safety Team at info@aztecsoccer.com.

Sender Name *

Sender Email *

Player Name *

Player's Date of Birth *

YYYY

What is the player's team name and age group *

What is the date of last attended Aztec training session or game? * *

YYYY

What is the date the player was diagnosed with Covid-19? *

YYYY

What is the Coach(es) name(s) (if known). *

Please provide any additional information that you think would be helpful as we conduct our contact tracing process.

I confirm that the information given in this form is true, complete and accurate. I agree to contact Aztec Soccer Club directly and immediately if the information above changes for my player at anytime. *

I confirm

Required

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