ZONE WITHDRAWAL/REPLACEMENT FORM

(To be used by Zone Director or Registrar to withdraw/replace a player)

It is up to the Zone Director or Registrar to make sure partners and teams know of any changes affecting them.

WITHDRAWN PLAYER :

Accreditation # / First name: / Last name:
Zone: / Type of change: Member / Sport/Event/Age Group
Any other pertinent info:
Reason for withdrawal:

Team/Partner field information: enter this information from the player’s database record

For dragon boat, ice hockey, slo-pitch, soccer, enter the name of the team

as it appears on the Sport Form: ______

For teams of 2-5 players list name(s) of other players the
withdrawn player was due to play with. / Accreditation #

REPLACEMENT PLAYER:

Replacement Player is □ a member □ a new member Zone Director/Registrar______

For registered members just fill out the boxes marked with an *

For new members fill out all boxes using information on their Membership and Registration Forms.

Refer to the note at the end of this form if the withdrawal results in a multiple change of events.

*Accreditation # / *First name: / *Last name:
*Zone for which they are playing / *Type of change: REPLACEMENT / *Sport/Event/Age Group
Any other pertinent info: / *DOB
yyyy/mm/day
*Address: / *City: / PC:
email: / *Home Phone: / *Gender M/F

Transportation needed while at the Games. Yes □ Not required □

Medical Information:

Emergency contact name and Relationship:
Phone # at which they can be reached during the Games

Submitted by: ______Date: ______

If this withdrawal has resulted in a need to change the events players are entered in the changes are listed

on the Realignment of Partners / Registered Events Form which has been submitted.



E-mail to Kyler at by noon 5 days prior the start of the Games.

After this deadline you should take the form to the Corrections Table during Accreditation

Revised December 2016