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<p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><b style=3D=
'mso-bidi-font-weight:
normal'><u>FFHA &#8211; CLUB OTTER Academic Award Application<o:p></o:p></u=
></b></p>

<p class=3DMsoNormal style=3D'text-align:justify'>Club Otter is an academic
recognition program designed to encourage youth hockey players to strive for
excellence in the classroom.<span style=3D'mso-spacerun:yes'>&nbsp; </span>=
The
program was developed to emphasize the importance of academic performance to
young players.<span style=3D'mso-spacerun:yes'>&nbsp; </span>The goal of the
program is to increase awareness among youth hockey players that performanc=
e in
the classroom is more important in life than performance on the ice.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>It is also the goal of the program=
 to
generate a lasting, measurable impact on high achievement in the
classroom.<span style=3D'mso-spacerun:yes'>&nbsp; </span></p>

<p class=3DMsoNormal style=3D'text-align:justify'>To be a member of Club Ot=
ter a
skater must maintain a 3.0/B average during the first two grading periods of
the current school year.<span style=3D'mso-spacerun:yes'>&nbsp; </span>Skat=
ers
who are in 5<sup>th</sup> grade through Bantams/12U in our youth program are
eligible for the recognition.<span style=3D'mso-spacerun:yes'>&nbsp; </span=
>Club
Otter members will receive a certificate from the FF Hockey Association at =
our
year end banquet and will be listed on the Club Otter board located on the
Hockey Association web site and at the ice arena.</p>

<p class=3DMsoNormal>To apply for the Club Otter recognition please complet=
e the
form below and submit it to the FFHA Club Otter, 2808 Bayview Heights Drive,
Fergus Falls, MN<span style=3D'mso-spacerun:yes'>&nbsp; </span>56537 or dro=
p off
at the ice arena concession stand.</p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>Deadline for
submission is March 12, 2010.<o:p></o:p></b></p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'>~~~~~~~~~~~~~=
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~</b></p>

<p class=3DMsoNormal>Skaters Name <u><span style=3D'mso-tab-count:7'>&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></u><span
style=3D'mso-spacerun:yes'>&nbsp;</span>Age <u><span style=3D'mso-tab-count=
:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp; </span></u><span
style=3D'mso-spacerun:yes'>&nbsp;</span>DOB <u><span style=3D'mso-tab-count=
:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp; </span><o:p></o:p></u></p>

<p class=3DMsoNormal>Address <u><span style=3D'mso-tab-count:7'>&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></u><span
style=3D'mso-spacerun:yes'>&nbsp;</span>City<u><span style=3D'mso-tab-count=
:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp; </span></u>
Zip<u><span style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </s=
pan></u></p>

<p class=3DMsoNormal>Parents <u><span style=3D'mso-tab-count:12'>&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp; </span></u></p>

<p class=3DMsoNormal>School <u><span style=3D'mso-tab-count:10'>&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></u><span
style=3D'mso-spacerun:yes'>&nbsp;</span>Grade <u><span style=3D'mso-tab-cou=
nt:3'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
 </span><o:p></o:p></u></p>

<p class=3DMsoNormal><u><o:p><span style=3D'text-decoration:none'>&nbsp;</s=
pan></o:p></u></p>

<table class=3DMsoNormalTable border=3D1 cellspacing=3D0 cellpadding=3D0
 style=3D'border-collapse:collapse;border:none;mso-border-alt:solid black .=
5pt;
 mso-yfti-tbllook:1184;mso-padding-alt:0in 5.4pt 0in 5.4pt;mso-border-insid=
eh:
 .5pt solid black;mso-border-insidev:.5pt solid black'>
 <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'>
  <td width=3D638 valign=3Dtop style=3D'width:6.65in;border:solid black 1.0=
pt;
  mso-border-alt:solid black .5pt;padding:0in 5.4pt 0in 5.4pt'>
  <p class=3DMsoNormal style=3D'margin-bottom:0in;margin-bottom:.0001pt;lin=
e-height:
  normal'>Circle or Underline Level of Skater</p>
  <p class=3DMsoNormal style=3D'margin-bottom:0in;margin-bottom:.0001pt;lin=
e-height:
  normal'><o:p>&nbsp;</o:p></p>
  <p class=3DMsoNormal style=3D'margin-bottom:0in;margin-bottom:.0001pt;lin=
e-height:
  normal'><span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>10U<span
  style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
  style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp; </span>Squirts<span
  style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Pee
  Wees<span style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp; </span><span
  style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp; </span>12U<span
  style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span
  style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp; </span>Bantams</p>
  <p class=3DMsoNormal style=3D'margin-bottom:0in;margin-bottom:.0001pt;lin=
e-height:
  normal'><o:p>&nbsp;</o:p></p>
  </td>
 </tr>
</table>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal><o:p>&nbsp;</o:p></p>

<p class=3DMsoNormal>I hereby grant authorization for the Fergus Falls Hock=
ey
Association (FFHA) committee to publish my child&#8217;s name on the CLUB O=
TTER
award that will be announced at the FFHA year end banquet, displayed at the=
 <st1:place
w:st=3D"on"><st1:PlaceName w:st=3D"on">Fergus</st1:PlaceName> <st1:PlaceTyp=
e w:st=3D"on">Falls</st1:PlaceType></st1:place>
hockey arena and the Fergus Falls Hockey Association web site.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>I understand that if I choose not =
to
sign this waiver, my child&#8217;s name will not be displayed at either sit=
e or
announced at the year end banquet.</p>

<p class=3DMsoNormal><u><o:p><span style=3D'text-decoration:none'>&nbsp;</s=
pan></o:p></u></p>

<p class=3DMsoNormal><u><span style=3D'mso-tab-count:7'>&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></u><span
style=3D'mso-tab-count:2'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp; </span><u><span
style=3D'mso-tab-count:4'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp; </span></u></p>

<p class=3DMsoNormal>Parent/Guardian signature<span style=3D'mso-tab-count:=
6'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>Date</p>

<p class=3DMsoNormal><b style=3D'mso-bidi-font-weight:normal'><span
style=3D'font-size:12.0pt;mso-bidi-font-size:10.0pt;line-height:115%'>Be su=
re to
include this form plus a copy of the player&#8217;s most recent report card=
.<o:p></o:p></span></b></p>

</div>

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