I'm sorry, I'm not available to work this tournament.
Every effort will be made to honor your preferences if
enough referees are available. Use below area for additional
information
Drinks, Snacks and Lunch are planned to be provided
*First Name:
*Last Name:
*Home Phone:
(ex. 804-555-5555)
Cell Phone:
(ex. 804-555-5555)
Work Phone:
(ex. 804-555-5555)
Date of Birth:
(ex. 01/01/1980)
*Email:
SSN:
(ex. 111-11-1111)
only if new to ODSRS
Address:
City:
State:
ZIP
Referee Self Rating:
Boys Center: Line:if new to ODSRS
Primary USSF Assignor:
if new to ODSRS
USSF Grade
(Ex 9, 8, 7, 6, 5)
I Play/Coach for:
(ex.
CHU15N)
Other team conflicts:
(ex. sibling, child, etc.)
Do not schedule me during these match times as I prefer to watch. Yes:
No:
Conflicts or other notes to the assignor: (if
you are new to ODSRS, providing additional info as to your experience allows us to
better know you ability and is greatly appreciated)
I certify I am a current USSF Official in good standing and to the best of my knowledge, all above information is true and correct. If not current, I agree to notify the assignor prior to the tournament if I fail to recertify for
2011 by then.
I further understand I am expected to have and bring at least 2 different color
jerseys along with a proper uniform for my matches and arrive at least 30
minutes prior to my first match. Failure to fully disclose conflicts or
meet the above requirements could result in
forfeiture of a portion of the match fees earned.
* Check this box to certify the above statement
This is an update of a previously submitted availability form.
