STATE TEAMS - Womens Masters Exemption Form

Full Name*

Mobile Number*

Contact Email*

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?*

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