Athlete Medical Upload

This form is for athletes who have already completed their Competitive Membership with Muaythai Ontario, but need to submit or update their medical information. Annual Medical Declarations and blood work are only valid for 12 months from the date shown on the completed form.
Athlete Province / Region*
Medical Information Upload
Athlete Legal Name*
First Last
Athlete Email*
Athlete Age (Years)*
Upload the Annual Medical Declaration here
All athletes participating in full contact competition must have a completed Annual Medical Declaration that has been completed no more than 12 months prior to the competition date. Both pages must be uploaded at the same time for a medical to be processed.
File types: .jpg, .jpeg, .png, .pdf
Maximum 20 MB.
Drop files here or

Accepted file types: jpg, jpeg, png, pdf.
Upload the scans of the completed HIV, HEP B, and HEP C tests here
All athletes age 16 years and older participating in full contact competition must have HIV, Hepatitis B Surface Antigen, and Hepatitis C Antibody screening blood tests that have been completed no more than 12 months prior to the competition date. All tests must be uploaded at the same time to be processed; individually uploaded tests will not be recorded.
File types: .jpg, .jpeg, .png, .pdf
Maximum 20 MB.
Drop files here or

Accepted file types: jpg, jpeg, png, pdf.
Rush Information Processing*
Rush information processing is required when submitting information 2 to 5 business days prior to an event an individual is participating in. Information submitted 1 business day prior to an event will not be processed.
Refer to image below for a rush fee schedule:
"OK" - Memberships are processed without a rush fee
"RUSH" - Only Memberships with a rush fee are processed
"NOT PROCESSED" - Memberships are not processed on these days, even with rush fees
"EVENT" - Event day
- I do not need Rush Processing ($0)
- I need my information rushed to be processed within 5 business days ($25)
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Payment Information
Coupon

Coupons are generally only used for administrative purposes.
Rush Information Processing Fee
Price: CAD$ 25.00 CAD
HST (13%)
Price: CAD$ 0.00 CAD
HST (15%)
Price: CAD$ 0.00 CAD
GST (5%)
Price: CAD$ 0.00 CAD
Total
CAD$ 0.00 CAD
Billing Information
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Cardholder Email*
Cardholder Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Athlete Medical Upload

Medical Information Upload

Payment Information

Billing Information