Alberta Gymnastics Federation - Alberta Gymnastics Injury and Accident Follow Up Form

Injury and Accident Follow Up Form

Please complete this form with any additional relevant information you have regarding a previously completed Injury and Accident Report Form. If you require to discuss a potential or ongoing insurance claim, please contact AGF by emailing info@abgym.ab.ca.

Who is completing this form?

You will receive a confirmation by email.

First name *

Last name *

Email *

Mobile *

Whose injury/accident are you providing follow up information for?

First name *

Last name *

When did the injury/accident take place?

Please select their Alberta Gymnastics Federation Gym Club *

Please provide a written description of new information related to the injury/accident: *

Please provide a written description of new information related to the injury/accident:

Use this section to upload any relevant photos:

Use this section to upload any relevant videos:

Electronic signature

Please sign your name inside the box

Type your name

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Email or mobile

Connection code

Waitlist

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If you need further assistance, please write to info@activitymessenger.com. Please include a screen capture if possible.