New Ref Data Form

If you have not refereed for me before, please complete and submit the form below. You will receive an email by March 7th which will have additional information to log in to the secure assigning pages of the website. There you will provide some additional information and complete availability using an online calendar.
Thank you for your interest in refereeing for Campton United. I look forward to seeing you.

PERSONAL INFORMATION last name : first name :

email :
home phone number :
date of birth (mm/dd/yyyy) :

REFEREE DATA USSF Referee Grade :

Please complete the following as accurately as possible. Be honest in your abilities. If anything, take a lower level at the beginning of the season and let me know you want to move into more difficult games.

I am comfortable doing games as a CENTER up to
I am comfortable doing games as an ASSISTANT REFEREE up to

AVAILABILITY & CONFLICTS

Please complete read all the following and check those which apply.

Will you be playing on a team this Spring Season? yes no
If yes, indicate team in space below. (indicate Name, age and gender)

Will you be coaching a team this Spring Season? yes no
If yes, what team? (indicate Name, age and gender)

Please identify any other known conflicts below.

COMMENTS

Any additional comments may be included here.

ADDITIONAL FORM

Once you submit this registration, if you have not already completed the Medical and Liability Release form found here, please submit one. It is required by the IYSA.

Fields in RED are required.

New (to me, at least) Soccer Referee Data