---

Western Region A/AA League Player Intent to Play Provincial Ringette

Any player wishing to play at the Provincial level for the 2011/2012 season within Western Region must register their intent online prior to March 31st, 2010 for AA A level Ringette. Please fill in the information below including any additional comments if appropriate. First Name Family Name Year of Birth ORA # Home Association Chatham Dorchester Elora/Fergus Exeter Forest Goderich Guelph Hanover Kitchener London Mitchell Owen Sound Seaforth St. Clements St. Jacobs St. Marys St. Thomas Stratford S.W.I.R.L. Tara Tillsonburg Waterloo Wellington North Woolwich Independent

2010-2011 Ringette Playing Season Details Association Chatham Dorchester Elora/Fergus Exeter Forest Goderich Guelph Hanover Kitchener London Mitchell Owen Sound Seaforth St. Clements St. Jacobs St. Marys St. Thomas Stratford S.W.I.R.L. Tara Tillsonburg Waterloo Wellington North Woolwich Out of Region Did not Play in 10/11 Division U10 (Novice) U12 (Petite) U14 (Tween) U16 (Junior) U19 (Belle) 18+ (Open) N/A Level C B A AA N/A Were You a 2-team player? No Yes

2011-2012 Ringette Playing Season Intent Willing to leave home Association Yes No Division U12 U14 U16 U19 18+ Level A AA Prov Petite Goalie ? No Yes

Additional Comments

IS EVERYTHING CORRECT ? No Yes

If everyting checked Enter Intent