OMHA 1998 Referees' School
LEVEL I & II
October 23-25, 1998
Guelph, Ontario

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APPLlCATION FORM
(Please Print)

Name:
Address:

Telephone: 
Sex (circle one):    M  F
Date of Birth:
Height:
Weight:

Are you presently a registered OMHA official:  Y   N
OMHA Card No.:
Are you recertifying at this school?   Y   N
Years of Officiating Experience:
OHF Division:      OMHA  MTHL  MHAO  OWHA
ROOM PREFERENCE:   Smoking    Non Smoking
Shirt Size:        S   M   L   XL   XXL

Mail Application Form to:
O.M.H.A. Referees' School Treasurer
796 7th Street East
Owen Sound, Ontario
N4K 119

FEE: S199.00 INCLUSIVE BEFORE SEPT. 15/98
     $225,00 AFTER SEPT. 15/98
to
Ontario Minor Hockey Association
Referees' School
(Honoured on first come first served basis).

Deadline for Application is:
October 1, 1998


Important:
A medical certificate is required if the applicant suffers from any
allergies or if he/she requires medical attention of any kind.

I give my approval to my participation in all activities of the
O.M.H.A. Referees' school and assume all risks all hazards incident
to such participation and do waive, release, absolve, indemnify and
agree to hold harmless, other than for wilful default on their part,
O.M.H.A. Referees' School or its representatives.
In signing the application, I certify that the applicant is in good
physical and mental health.

I acknowledge that I have read and understood the conditions of this
application and the conditions in the registration pamphlet (or
web page) and agree to abide by their  terms.

Signature of applicant or if under age 18, parent or guardian.
Please sign below:


     _______________________________________ Date: ________________