USA ROLLER SPORTS TRIALS FOR THE 2011 FIRS JUNIOR MEN AND JUNIOR WOMEN S USA WORLD INLINE HOCKEY TEAM

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1 USA ROLLER SPORTS TRIALS FOR THE 2011 FIRS JUNIOR MEN AND JUNIOR WOMEN S USA WORLD INLINE HOCKEY TEAM Junior Inline Hockey athletes may be evaluated at either of two trials that will be used to select a Men s Junior Inline Hockey Team and a Women s Junior Inline Hockey Team for the following two events: II Junior Women Inline Hockey World Cup Huntington Beach, California July 5 9, A 14 member team (including two goalies) will be selected to participate (plus 2 non-participating alternates). Junior Women s Team members must pay all of their own expenses to participate. V Junior Men Inline Hockey World Championships - Roccaraso, Italy - July 1 - July 10, (Competition July 4-9) A 14 member team (including two goalies) will be selected to participate (2 non-participating alternates will also be named). Junior Men s Team Members must pay all of their own expenses to participate. East Trials: May 13-15, 2011 at BladeRunner's Complex, 66 Alpha Drive West, Harmarville, PA (412) (during these same dates and at the same location, trials will also be conducted to select the Senior Men and the Senior Women s Inline Hockey World Teams. West Trials: May 21-22, 2011 at The Rink, 4325 Prado Road, Corona, CA (951) Inline Hockey Athlete Eligibility: Athletes must be 14 years of age or older and cannot have reached their 19 th birthday as of January 1, 2011 and qualify by gender. Athlete will be a current member of USA Roller Sports by virtue of registration (application enclosed). Membership expires annually on December 31. Passport proof of U.S. citizenship required, only U.S. citizens are eligible to represent our country at the FIRS World Championships/Cups. Participant Fee for Trials: $150.00, which includes full USA Roller Sports membership for 2011 (complete and return the enclosed USARS membership form with your trials application). An additional $75 late fee shall be required with applications received after April 1, Entry forms will not be processed if payment does not accompany the form. Money orders, checks payable to USA Roller Sports or credit cards (Visa, MasterCard, American Express or Discover) will be accepted. If sending an entry form and membership application by fax, credit card information needs to be complete. Do not send cash. Mail or fax entry forms and fees to: USA Roller Sports, 4730 South Street, PO Box 6579, Lincoln, NE fax: No applications accepted after May 6 No on-site registrations accepted. Responsibility for Trials Participation: Players are responsible for the cost of their food, housing, transportation to and from the trials site and other miscellaneous expenses involved with participation. Players are required to bring full hockey gear. All goalie helmets must meet USA Roller Sports standards and have the appropriate HECC certification sticker intact. Housing in Harmarville: Comfort Suites, 2801 Freeport Road, Pittsburgh, PA 15238, Days Inn Harmar, 6 Landings Drive, Pittsburgh, PA 15238, A special guest rate is available ask for the Hockey Rate. **All participants must book their own hotel accommodations at one of these two Harmarville hotels (if you reside 75 miles or further from the trials location). Proof of hotel accommodations will be required at the trials check-in. Housing in Corona: Ayres Suites Corona West, 1900 Frontage Road, Corona, CA Contact Nancy Legters at (951) x Holiday Inn Express Corona, 1550 Circle City Drive, Corona, CA Contact Robert Gutierrez at (951) robert@finehospitality.com - ask for "The Rinks Corona Inline" discount rate Travel Arrangements for the Junior Men and Junior Women s USA Teams - Athletes selected as members of the 2011 Junior USA Teams will be responsible for their travel, housing, food and insurance expenses (as coordinated via USA Roller Sports for the Junior Men s Team). Coaches, uniform and equipment TBD and entry fees will be provided.

2 USA ROLLER SPORTS TRIALS REGISTRATION FORM 2011 World Inline Hockey Championships/Cup Junior Team USA Trials East - Bladerunners Inline Complex - May 13-15, 2011 or West - The Rink May 21-22, 2011 Name: Age as of January 1, 2011: Mailing Address: DOB: Male, Female City: State: Zip Code: Daytime phone: ( ) _ Evening Phone: ( ) Cell Phone: ( ) Work Phone: ( ) Fax: ( ) Athletes must meet the eligibility criteria listed on the reverse side of this application. I wish to register to participate in: Junior Women s Team Trials, Junior Men s Team Trials East Trials - Pennsylvania, West Trials California DISCOUNTED REGISTRATION DEADLINE FRIDAY, APRIL 1, 2011 Trials Fee if Received by April 1, 2011: $ (includes full USA Roller Sports membership for 2011 you must complete and return the enclosed 2011 membership form). An additional $75 fee shall be required with applications received after Friday, April 1, NO APPLICATIONS ACCEPTED AFTER MAY 6 - NO ON-SITE REGISTRATIONS ACCEPTED Accepted Payment Methods: Check Money Order Credit Card Checks should be made payable to USA Roller Sports. Do Not Send Cash CREDIT CARD PAYMENT INFORMATION MasterCard, Visa, Discover, American Express Exp. Date: Name as it appears on card: Card # _ Security Code: Zip Code of Billing Address: By my signature below, I agree to abide by the rules of USA Roller Sports and the United States Olympic Committee. I understand these Trials represents a serious training opportunity and I will conduct myself accordingly both during and outside of scheduled session times. I also acknowledge that participation in these Trials is a privilege, and I am aware that inappropriate conduct may result in forfeiture of this privilege and dismissal from the Trials. If qualified to a team, I also agree to participate in the FIRS World Championships/Cup at my own expense. Player's Signature: Parent or Guardian if Minor Age: Date: Date: CIRCLE ONE SIZE EACH Preferred Player Position: Goalie, Offense, Defense Uniform Jersey Size: M - L - XL XXL Goalie (Ace Jersey) Shirt Size: M - L - XL - XXL Uniform Pant Size: M - L - XL - XXL (Ace Jersey) Shorts Size: M - L - XL - XXL Preferred Player #: or Player Helmet Size: (Reebok) Glove Size: (Reebok) Wheel Size: Men and Women Stick Size and Curve (Reebok stick) (Items received may be subject to support of sponsors)

3 Feburary 2011 TO: RE: Trials Applicant (participant eligibility subject to criteria listed on registration form) Trials for 2011 USA Junior Men and Junior Women s World Inline Hockey Teams This letter and forms are sent to you for use in registering to participate in the East Junior 2011 Team USA Selection Camp, scheduled for the Bladerunners Inline Complex in Harmarville, Pennsylvania, May 13 15, 2011 or for the West Junior 2011 Team USA Selection Camp at The Rink in Corona, California, May At the Harmarville trials, four teams will be considered (with the Senior Teams being selected): XVII Senior Men Inline Hockey World Championships Roccaraso, Italy July 11 July 16, X Senior Women Inline Hockey World Championships Roccaraso, Italy July 4 July 9, 2011 An additional evaluation trials will be held on May 21 and 22 in Corona, California, for Junior eligible athletes in Corona, to qualify athletes to participate on behalf of the USA: V Junior Men Inline Hockey World Championships Roccaraso, Italy July 4 July 9, 2011 II Junior Women Inline Hockey World Cup Huntington Beach, California July 6 9, 2011 After you have received your Team USA Trials registration confirmation by e mail, make your plans to travel to the trials of your choice in accordance with the schedule information provided with this letter. You should plan to be present at the first instance noted and depart following the last scheduled scrimmage, since the schedule provided is subject to change based on the actual registration for each team trials. Registration Fee and Deadlines $150 if received by FRIDAY, APRIL 1, 2011 (includes full USA Roller Sports membership for 2011). An additional $75 late fee shall be required of applications received after Friday, April 1, No applications will be accepted after Friday, May 6 and no on site registrations will be permitted. Complete and return the following with payment: USARS Participant Registration Form 2011 Membership Application must be completed and returned with trials application (all first time members must include verification of their birth date, such as a clear copy of their birth certificate, driver s license, passport face page, school identification card, insurance card, etc.).

4 Page 2 East: Trials Site: The site of the Trials is the Bladerunners Inline Complex, 66 Alpha Drive West, Harmarville, PA (412) Athletes will be able to store their equipment the rink under lock and key. You can visit their website for more information on the facility at Housing During Trials: Two hotels are located within walking distance. Ask for the Hockey Rate at: Comfort Inn Harmar, 2801 Freeport Road, Pittsburgh, PA 15238, , (fax). Manager: Yvonne Zelahy, E mail: managercihv@kratsaproperties.com. For more information, see Days Inn Harmar, 6 Landings Drive, Pittsburgh, PA 15238, , (fax). Manager: Leah Macura, E mail: managerdih@kratsaproperties.com. For more information, see Note: All participants must book their own hotel accommodations at one of these two hotels (if you reside 75 miles or further from the trials location). Proof of hotel accommodations will be required at check in. West: Trials Site: The Rink, 4325 Prado Road, Corona, CA (951) Housing During Trials: Ayres Suites Corona West, 1900 Frontage Road, Corona, CA Contact Nancy Legters at (951) x304 Holiday Inn Express Corona, 1550 Circle City Drive, Corona, CA Contact Robert Gutierrez at (951) robert@finehospitality.com ask for "The Rinks Corona Inline" discount rate 2011 World Inline Hockey Team USA Selection Committee in Harmarville The following evaluators will be present: Chuck Thuss, Chalie Sgrillo, Gerry Lulove, Ken Murchison, Mark Vittese, Jon Roux, and athlete representative Terry Shook. Also present Keith Noll Administration. A minimum of two of the above will also be present at the West Trials in Corona. Team USA Staff Junior Men s Team Coach Jeff Bond Junior Men s Assistant Coach/Team Manager Gerry Lullove Athletic Trainer Yet to be Named Junior Women s Team Coach Mark Vittese Junior Women s Assistant Coach Andy Datlo

5 Page 3 Championships/Cup Travel Arrangements for Junior USA Teams Athletes selected as members of one of the 2011 Junior USA Teams will be expected to travel at their own expense to the competition site. Participation costs will include airline, hotel, food, and travel insurance. Uniforms (and equipment TBD) will be provided, along with team entry and staff as noted above. Arrangements for the Junior Men s Team will be coordinated via USA Roller Sports. Dates and hotel information will be provided for use by the Junior Women s Team in attending the World Cup. Junior Men s Team Participation Schedule Subject to Modification # Days Junior Men s World Championships Roccaraso, Italy 1 July 1, 2011 Arrive International USA Departure City and Depart 2 July Arrive in Rome (Fiumicino) two hour bus to Roccaraso 3 July 3, 201 Official Practice 4 July 4, 2011 Competition 1 5 July 5, 2011 Competition 2 6 July 6, 2011 Competition 3 7 July 7, 2011 Competition 4 8 July 8, 2011 Competition 5 9 July 9, 2011 Competition 6 10 July 10, 2011 Depart for USA Junior Women s Team Participation Schedule Subject to Modification # Days Junior Women s World Cup Huntington Beach, California 1 Sat July 5 Arrive and Practice July 6 9 Competition 6 July 10 Depart We are excited about the opportunity that these important international events present for you as athletes and for the USA. Sincerely, Brent Benson USA Roller Sports Hockey Director Phone: ex. 13 bbenson@usarollersports.org

6 NOTE: West Trials Schedule for Corona, California TBD SCHEDULE FOR FROM JON 2011 USA SENIOR MEN S, SENIOR WOMEN S, JUNIOR WOMEN S & JUNIOR MEN S WORLD INLINE HOCKEY TEAM TRIALS BladeRunners Harmarville, Pennsylvania Friday, May 13 7:30 9:00 pm Men s (Player check in 6:00 7:00 pm) 9:00 10:30 pm Women s (Player check in 8:00 9:00 pm) Saturday, May 14 8:00 9:45 am Men s Skill Session 10:00 10:15 am Men's Team Meeting 10:00 11:45 am Women's Skill Session 12:00 12:15 pm Women's Team Meeting 12:15 2:00 pm Break for Lunch 2:00 3:45 pm Women s Scrimmage 4:00 5:45 pm Men's Scrimmage 5:45 7:00 pm Break for Dinner 7:00 9:00 pm Women's Scrimmage 9:00 11:00 pm Men's Scrimmage Sunday, May 15 8:00 am 9:00 am Women's Final Scrimmage 9:20 am Women s Team Posting / Drug Testing / Paperwork 9:00 am 10:00 am Men s Final Scrimmage 10:20 am Men s Team Posting / Drug Testing / Paperwork (The Pittsburg airport is located approximately 45 minutes from BladeRunners in Harmarville)

7 VERIFICATION OF BIRTH DATE REQUIRED TO ESTABLISH COMPETITIVE AGE IN THE USA ROLLER SPORTS MEMBERSHIP DATA BASE Full membership in USA Roller Sports requires verification of competitive age for those registering for their first time, as noted on the application. Once your competitive age is established, it is never again necessary to provide this information. Acceptable forms of verification include a copy of any one the following: Birth Certificate Driver s License School ID Insurance Card with Date of Birth Face page from passport Please fax, mail or scan and e mail a clear copy so we can assure your name is in our membership data base. If you have any questions regarding this, please contact Brent Benson at our phone number below, or by e mail at bbenson@usarollersports.org. Thank you.