Gameday Medical

Contact Details
Legal NameOli DeRuyter
EmailEmail hidden; Javascript is required.
Phone07866311217
TeamNational Team
Jersey #12
Date of Birth03/10/1985
Next of Kin DetailsIn the case of emergency, who is the best person to contact
NameSam DeRuyter
RelationSpouse
Phone07881978117
Travel & Accomodation Details
Travel ArrangementFlight
Inbound AirlineBA
Inbound Airport CodeHAM
Inbound Flight #BA964
Landing Date05/04/2024
Outbound AirlineBritish Airways
Outbound Airport CodeLHR
Outbound Flight #BA0969
Departure Date07/04/2024
Car Registration
Who's the Main Driver?
Travel Comments/Details
Hotel / Accommodation NameAirBnB with Adam O'Reilly
Others StayingAdam O'Reilly
Hotel / Accomodation Comments
Medical
Medical ConditionsNo
Condition Details
Pre-existing injuriesNo
Injury Details
Medication(s)No
Medication Details
AllergiesNo
Allergy Details
Agreements
Authority reporting Approval
  • agreed
Insurance Coverage
  • agreed
Medical Release
  • agreed
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