New Ref Data Form

Please complete the information below if you are interested in refereeing ANY games this Spring Season. Once completed and sent you will receive a confirmation that it was received and a link to the new assigning page. There, you will need to provide some additional information and complete your 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 (not just a Campton team, any team)? 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 complete one and send it to me. It is required by the IYSA. Also, if you are 18 years of age or older, IYSA requires you to complete a BACKGROUND CHECK. Please do so as soon as possible. I cannot assign you games without it.

Fields in RED are required.

Soccer Referee Registration Form