Western Region Ringette - 2011 Officiating Clinic Request Form

Name:		Association	Select Association Chatham Dorchester Elora/Fergus Exeter Forest Goderich Guelph Hanover Independent Kitchener London Mitchell Owen Sound Seaforth St. Clements St. Jacobs St. Marys St. Thomas S.W.I.R.L. Tara Tillsonburg Waterloo Wellington North Woolwich Other - Out of Region
Email:		Phone Number
ORA Number		Current Referee card level

Clinic Requested

Select from the following clinics Level 1 clinic for new referees Sunday Oct 16th 8:00am to 5:00PM in Forest Refresher level 1/2 Tuesday October 18th 6:00PM-9:30PM Kitchener Lions Arena Refresher level 3/4 Sunday October 22nd 8:00AM-12:00 Waterloo RIM Room 104 Rule Clinic for Coaches Saturday October 22nd 1:00PM-4:00PM Waterloo RIM Room 104 Refresher level 1/2 Sunday October 23rd 8:00AM-12:00 Guelph upstairs at Exhibition arena Rule Clinic for Coaches Sunday October 23rd 1:00PM-4:00PM Guelph upstairs at Exhibition arena Refresher level 1/2 Saturday October 29th 8:00AM-12:00 Exeter Hensal Arena Refresher level 1/2 Tuesday November 8th 5:30PM-9:30PM Guelph upstairs at Exhibition arena Rule Clinic for Coaches Thursday November 10th 6:00PM-9:00PM Waterloo RIM Room 104

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