Practice Medical Form

Contact Details
Legal NameAaron Ainsworth-Bowcott
EmailEmail hidden; Javascript is required.
Phone07378838637
TeamNational Team
Date of Birth22/10/1993
Next of Kin DetailsIn the case of emergency, who is the best person to contact
NameAntony Ainsworth
RelationParent
Phone07719605799
Travel & Accomodation Details
Travel ArrangementFlight
Travel Comments/Details

Manchester to Hamburg 4/4
Hamburg to Manchester 7/4

Hotel / Accomodation NameAO hammer kirsch
Others StayingNone
Medical
Medical ConditionsNo
Pre-existing injuriesNo
Medication(s)No
AllerigiesNo
CommentsAre there any other items that you believe the Coaches/Organisations should be made aware of?
Agreements
Authority reporting Approval
  • agreed
Insurance Coverage
  • agreed
Medical Release
  • agreed
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