Shusw ap Ringette Association
Registration
2017/2018
Save $50
Pay before
June 30th
www.shuswapringette.ca
Player Last Name
 Male  Female
Player First Name
ss
Date of Birth Day/Month/Year
BC Care Card Number
Parent/Guardian Last Name
Parent/Guardian First Name
Street Address
City, Province, Postal Code
Home Phone
Cell Phone
Work Phone
Parent/Guardian Email
Player Email
Does your child have any health challenges or special conditions?  No  Yes If yes, briefly explain.
The following information is needed to accurately register your child
What age category did you play last season and what level? Eg. U19A __________________________
For the playing season of 2017/2018 select age as of December 31, 2017.
 U9 (2013-2010)  U10 (2008/2009)
 U16 (2002/2003)  U19 (2001-1999)
 U12 (2006/2007)
 Open (1999 or earlier)
Division
Player Fee if Paid
Before June 30th
 U14 (2004/2005)
 Affiliate Player
Player Fee if Paid
After July 1st
U9
$200
$250
U10-U19
$350
$400
Open
$225
$250
New Player Fee-U9
$200
$200
(First time player, attach copy of Birth Certificate)
New Player Fee-All Other Divisions
$350
$350
Fee Paid
(First time player, attach copy of Birth Certificate)
Family discount (First registered player pays full amount,
additional family members of same household apply
discount)
Affiliate Player
$50 discount
$125
$50 discount
$125
$100 with own Equipment $100 with own Equipment
Goalie Incentive Program
- see website for
$150 borrow from SRA
$150 borrow from SRA when available
details, form must be attached to registration
Total Payable
Cheques are payable to SHUSWAP RINGETTE ASSOCIATION, all fees are subject
to SRA refund Policy, NSF Cheques are subject to applicable fees/charges,
FUNDING OPTIONS
 Athletics for Kids, A4K, is another option for funding for children’s sports, visit their website at www.a4k.ca for further details.
Please attach a copy of your completed form to your SRA Registration Form.
 Kidsport/Jumpstart- for funding information and registration log onto www.kidsportcanada.ca and find Salmon Arm under
the “Find a Chapter” tab. Please attach a copy of your completed form to your SRA Registration Form.

SRA Payment Plan Option - download the SRA Payment Policy at www.shuswapringette.ca
In the event of financial hardship, please contact the SRA Registrar for further information.
Both sides of this form must be completed.
VOLUNTEER PROGRAMS
Every team in the Shuswap Ringette Association (SRA) is in need of volunteers to help make Ringette a positive experience for the
players. If you would like to have fun, meet new people and get involved in a great sport with your child, it's easy! Shuswap Ringette may
pay for certain coaching certification and training programs. Please see our website at www.shuswapringette.ca to learn about how you
can volunteer for Head Coach, Assistant Coach, Team Manager, Trainer, Fundraising, Team Volunteer, Parade , Banquet/AGM, ComeTry-Ringette, Playdays, Board of Directors, Santa Skate, Mentorship Program (U14 and older), Referees Program- if you are 13 years of
age or older, interested in earning extra money and can commit to a training session of five hours.
RELEASE OF LIABILITY AND WAIVER OF CLAIMS and PHOTO RELEASE, PLEASE READ CAREFULLY
I, the parent/guardian of the above child, give my consent for the child’s participation in all association and league
activities. I assume all risks, including those incurred going to and from, or participating in ringette functions. I hereby
release Shuswap Ringette Association (SRA), and anyone who volunteers in any way for the SRA, from any claim or
blame arising from accidental injury to this child. I hereby authorize team staff, league or tournament officials to seek
medical assistance when required and for medical care to be administered as needed. I am aware that all teams will be
formed based on SRA and British Columbia Ringette Association (BCRA) policy. I have read and understand the attached
registration information sheet.
I give SRA authorization to publish photos that include my child.
Parent/Guardian Signature:
Date:
IMPORANT REGISTRATION DATES
April 1
June 30
August 31
September 1
December 1
Player Registration Opens for current playing season.
Early Registration Discount. Save $50 off your player registration fee if your registration application and payment in
full or accompanied by post-dated cheques as per the Installment - Payment Plan Policy is received by SRA prior to
4:00 PM on this date.
Critical registration deadline for determining if, and how many, SRA teams will have for the season. If you are
interested in your child playing on a team, you are strongly encouraged to have your player registration application in
prior to this date. If not enough registration numbers are received by this date, some divisions may be cancelled or
combined for the season.
Players registering after this date, with the exception of U9, will either: a) be placed on a team within their age division;
or b) put on a waiting list and registered on a first-come, first-served basis.
Registration Closed. As per BCRA Policy. No players will be accepted or added after this date. If your registration
application is still on a waiting list, your registration will be cancelled, and your payments refunded or returned.
For insurance purposes Registration Form and first payment must be received by
the Registrar prior to the first ice session.
Completed Registration Form and Payment(s) can either be mailed to the address provided below or
placed in the Ringette Drop Box located at the Shaw Center.
Mail to: Shuswap Ringette Association
Attention: Registrar
Box 866, Salmon Arm, B.C. V1E 4N9
REGISTRAR USE ONLY
 Birth Certificate Received
 Entered in Karelo #
Date Received:
Amount Paid $
 Family Discount Applied
 Cash
 Cheque #_
 Payment Plan
Chq#1
Chq#2_
Chq#3
 Tax Receipt Issued
Kidsport/Jumpstart/Athletics for Kids/A4K
 Application Received
 Payment Received Date:
 Cheque #_