Student Name: *

Are you attending the Langley School Presentation?

Yes No

Age: * Sport Played: -FootballNetballCricketRugbyBasketballTennisOtherNone If your sport is football, please check box if you are attending the showcase game ($10)

You will let us know if the participant has been in contact with anyone that has been exposed to Covid-19 and/or has symptoms, directly or indirectly before the event..

Yes No

Parent / Guardian Email Address: *

* indicates required fields