ALLIANCE Hockey Officiating Program - Vaccination Validation Form (Minor Hockey Alliance of Ontario)

Print ALLIANCE Hockey Officiating Program - Vaccination Validation Form
All officials must complete in order to comply with the ALLIANCE Hockey Vaccination Policy.
Personal Information
Please complete.
  1. Your ID# can be found in your Hockey Canada Registry Account
  2. (ie Sept. 1, 2021) - Information will only be used for tracking purposes.
  3. Example: ###-###-####
  4. Example: [email protected] Your submission will be sent to this address.
  5. i.e. London Referees Group
  6. Check All That Apply
Vaccination Record
Please upload your vaccination record.

  1. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
    Maximum # Files: 2. Maximum File Size: 4MB.
  1. All documentary records about COVID-19 vaccinations and accommodations for Affected Persons will only be collected, used, retained, or disclosed by ALLIANCE Hockey or any of its Member Associations as may be necessary for legitimate operational purposes or as directed or requested by governmental authorities or as may be required for legal purposes.

    Until no longer required, records will be held in a secure location.


Human Validation