This form is for athletes who have already completed their Competitive Membership with Muaythai Canada, 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 Legal Name* First Last Athlete Email* Athlete Age (Years)*Athlete Province*(Please Select)AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonAthletes from Ontario must upload their medicals to the Muaythai Ontario Medical Form.Annual Medical DeclarationAll 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.Upload the Annual Medical Declaration hereFile types: .jpg, .jpeg, .png, .pdf Maximum 20 MB. Drop files here or Accepted file types: jpg, jpeg, png, pdf. Laboratory Tests for HIV, HEP B, & HEP CAll 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.Upload the scans of the completed HIV, HEP B, and HEP C tests hereFile types: .jpg, .jpeg, .png, .pdf Maximum 20 MB. Drop files here or Accepted file types: jpg, jpeg, png, pdf. I understand that for competition in Alberta I am required to bring a physical copy of my medical information to each event.* Yes CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.