Injury Report

We can support our players at GUPA by providing benefits and partial financial coverage for treatment should you be injured during play in one of our leagues or tournaments. We cannot guarantee coverage, but we will work with you and will do our best to support you.

Name *

First

Last

Email *

Date of Incident *

Document Upload

Drag & Drop Files, Choose Files to Upload

Attach receipts and invoices for treatment of injury. Allowed formats are: .png, .gif, .jpg, .doc, .docx, .xls, .xlsx, .pdf

Additional Details *

Include how the injury occurred, if there are concerns around dangerous play, issues with field conditions, etc.

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