STATE TEAMS - Womens Masters Exemption Form

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THIS EXEMPTION MUST BE SUBMITTED AT LEAST 24 HOURS PRIOR TO THE FIRST GAME/SESSION.
SUBMITTING THIS SURVEY DOESN'T MEAN YOU ARE EXEMPT, THE EXEMPTION STILL NEEDS TO BE APPROVED. ONCE A DECISION HAS BEEN MADE YOU WILL RECEIVE AN EMAIL.

PERSONAL INFORMATION

Full Name*

Mobile Number*

DOB*

Primary Association*

EXEMPTION INFORMATION - SUPPORTING DOCUMENTS MUST BE UPLOADED.
YOU WILL BE EMAILED THE DECISION OF YOUR EXEMPTION ONCE IT HAS BEEN MADE.

Age Group you are seeking an Exemption From?*

Which of the following are you seeking an Exemption From?*

If Other, please explain.

What reason are you applying for an Exemption for?*

If Other, please explain.

Please upload your supporting documents. (Doctor Certificate, Employer Letter, Ect)

Choose file...

Max 5MB

Who is a hockey reference we can contact?*

Your hockey references mobile number?*

Name of Applicant or Parent/Guardian if applicant is under 18 years of age.*

If you submit an exemption for any squad weekend or trial you are then unable to compete in your local competition or any other match for that weekend.