Contact Details | |
---|---|
Legal Name | Jake Lord |
Email hidden; Javascript is required. | |
Phone | 07881388473 |
Team | National Team |
Jersey # | 40 |
Date of Birth | 15/12/1992 |
Next of Kin Details | In the case of emergency, who is the best person to contact |
Name | Deepa Chand |
Relation | Civil Partner |
Phone | 07585227749 |
Travel & Accomodation Details | |
Travel Arrangement | Flight |
Inbound Airline | |
Inbound Airport Code | |
Inbound Flight # | |
Landing Date | |
Outbound Airline | |
Outbound Airport Code | |
Outbound Flight # | |
Departure Date | |
Car Registration | |
Who's the Main Driver? | |
Travel Comments/Details | |
Hotel / Accommodation Name | Hotel Mercedes Hamburg |
Others Staying | Michael French & Dan Hughes |
Hotel / Accomodation Comments | |
Medical | |
Medical Conditions | No |
Condition Details | |
Pre-existing injuries | Yes |
Injury Details | Patellar Tendonitis (left knee) |
Medication(s) | No |
Medication Details | |
Allergies | No |
Allergy Details | |
Agreements | |
Authority reporting Approval |
|
Insurance Coverage |
|
Medical Release |
|