Player Registration Form
Name:
Team:
Beverly Hills Chinese Baptist Church
Central Baptist Church
Christ Evangelical Centre of Australia
JookFook
NDFC
North Side Chinese Alliance Church
Praise Evangelistic Free Church Australia
St Matthew
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Mobile:
Email:
Previous Serious Injury:
YES
NO
If YES, please specify:
Have you ever had, experienced symptons or been diagnosed with: heart complaints; high blood pressure; chest pain; stroke; liver; kidney; bowel; intestinal or bladder disease; diabetes; cancer; or other tumours; asthma; respiratory or blood disorders; stress; anxiety; depression, mental or nervous disorders; Chronic Fatigue Syndrome; epilepsy or other neurological disorder?
YES
NO
Have you ever had or do you have: arthritis; rheumatism; paralysis; loss of use of a limb; muscle; joint or back or neck problem; RSI; hearing, sight or skin problems?
YES
NO
Have you ever taken drugs or medication of any kind (prescribed or otherwise) excluding aspirin, cold and flu medicatin?
YES
NO
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