Practice Medical Form

Contact Details
Legal NameAdam O'Reilly
EmailEmail hidden; Javascript is required.
Phone07534416010
TeamNational Team
Date of Birth23/06/1984
Next of Kin DetailsIn the case of emergency, who is the best person to contact
NameCharlotte O'Reilly
RelationSpouse
Phone07896665592
Travel & Accomodation Details
Travel ArrangementFlight
Travel Comments/Details

Flying and hiring a car, as usual. Landing Thursday, flying back Sunday.

Hotel / Accomodation NameAn apartment in the city.
Others StayingJake Honour, Caius Magero, and Oli DeRuyter
Hotel / Accomodation Comments

No comment.

Medical
Medical ConditionsYes
Condition Details

Have a recent injury that is being managed as best I can. I have had plantar fasciitis in my left foot, aswell as my calf and Achilles being tight, has been treated but needs massaging and taping as a precaution.
Been living in Crocs for past month.

Pre-existing injuriesNo
Medication(s)No
AllerigiesNo
CommentsAre there any other items that you believe the Coaches/Organisations should be made aware of?
Additional Comment

N/A

Agreements
Authority reporting Approval
  • agreed
Insurance Coverage
  • agreed
Medical Release
  • agreed
Sealand Seahawks

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