PETOSKEY AUTUMN BLAST SEPTEMBER 8th-10th ... AWS

PETOSKEY AUTUMN BLAST SEPTEMBER 8th-10th , 2017 TOURNAMENT REFEREE CARD Name: ____________________________ Age: ______ Sex: _______ Address:________________________City:____________State:______Zip:______ Phone: Home(_____)_____________ Cell(_____)_____________ Email address: ______________________________________ USSF grade/class: ______ Yrs. Experience:______ Max # of games per day:______ Available Friday Night? YES or NO Available Saturday? YES or NO

Available Sunday? YES or NO

Which can you referee or prefer: BOYS_______

GIRLS______

No Preference____

Age Division that you can referee or prefer: ______No Preference ______U9-U10

______U11-U12

______U13-U14

______U15-U19

Check here if housing is needed: ____ (this is for referees ONLY, no families or players) I would like to room with: _______________________________________ Refereeing assignments will be made so as to avoid conflicts with games for the team on which your child plays. Team Name:_________________________ Questions? Call PYSA Referee Assignor, Justin Matzka (231)340-0738 or email [email protected] If you would like to referee with a set group, please list their names on this card.

PYSA will be using Game Official for scheduling. All officials must make themselves available for the weekend of the tournament. PLEASE RETURN BY AUGUST 10th TO: PYSA P.O Box 751 Petoskey

MI

Form can be emailed also to: [email protected] Or call Justin Matzka PYSA Referee Assignor at 231-340-0738

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