Gloucester - Cumberland Ringette Association www.gloucester-cumberland-ringette.ca Registration Form 2010 - 2011

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(Please type information in the appropriate fields, print then sign)

Birthdate : Name : Address : City : Postal Code : Telephone No.: Email address :

______________________________________________________    ______________________________________________________    ______________________________________________________    ______________________________________________________    ______________________________________________________    ______________________________________________________    ______________________________________________________

** Please provide a current e-mail address only to be used for Newsletter and Registration purposes**

If you do NOT wish your child's picture to appear in any GCRA publication/promotion (including team and individual photos in the tournament program and on the GCRA website), please check here.
______________________________________________________________________________________________

I give permission for my (child's) name to be released to governing bodies of ringette, according to the Access to Information Act.

I or the parent/guardian agrees that the ORA or any of its teams, members, or other officials will not be held responsible for any injury or accident, which may occur before, during or after games, practices or tournaments, or while travelling to or from games, practices or tournaments.

Name (printed) : ______________________________________________________

Signature: _____________________________________ Date: ______________________________

This registration cannot be accepted unless it is signed by the registrant's parent or legal guardian or the player if 18 years or older.

Can you help your association?
Coach			GCRA Tournament

Payment amount:  $______________ Cash or ChequeProof of age seen by:   _____________________   Receipt issued: Y or N

2010 / 2011 Registration Fees

Check the applicable box below

Level that applies		(Birth Year/	Post marked before August 20	Postmarked after August 20
	Bunny	2004/2005/2006	$175	Bunnies - Late fee does not apply
	Novice  (U10)	2001/2002/2003	$450	$500
	Petite** (U12)	1999/2000	$450	$500
	Tween** (U14)	1997/1998	$450	$500
	Junior** (U16	1995/1996	$450	$500
	Belle**  (U19)	1992/1993/1994	$450	$500

             

** Check if you wish to participate in "A" Level Competitive tryouts   (Including Petite Provincial) A Fee of $60 for Competitive Try Outs must be added to the above registration fee. Unless you have already paid for "AA" spring tryouts. Check if you have already paid the $75. Tryout fee at the spring "AA" tryouts .

	Ø	New players must provide a copy of their birth certificate attached with the registration..
	Ø	Players turning 18 years of age between April 1st 2010 and March 31st 2011 must provide a copy of their birth certificate attached with the registration.
	Ø	No player will be allowed onto the ice until they have completed the registration process. For registration to be considered complete, payment must be included with the registration form.

     Make cheque or money order payable to Gloucester-Cumberland Ringette Association, for September 1, 2010
     Please do not send cash through the mail.    
     Cheques will not be deposited until after September 1st.
     NSF cheques will be charged an administrative fee of $25.00.

Receipts for the 2010 tax year will be given in January 2011 upon full payment confirmation.

For information on refund policies, please consult the Policy and Procedure - Registration Fee Payment and Refund Policy section on the website.

For more information please visit our website or contact Maria Joynson (registrar) at (613) 837-7369