Presidio Cup Youngers (Leanne)

PRESIDIO CUP YOUNGERS (LEANNE ASSIGNS)

December 10h & 11th, 2011

___________________________________________________________

WILL BE AVAILABLE AS FOLLOWS:

DECEMBER 10TH SATURDAY AM PM

DECEMBER 11TH SUNDAY AM PM

COMMENTS: ___________________________________________________________

NAME __________________________________________________ AGE _________

ADDRESS ______________________________________________________________

PHONE W/ AREA CODE _______________________ CELL# _____________________

YEARS OF REFEREE EXPERIENCE _____

EMAIL __________________________________________________________________

I AM COMFORTABLE AT THE FOLLOWING LEVEL:

REFEREE U/__________________________________ BOYS GIRLS

AR U/__________________________________ BOYS GIRLS

CURRENT USSF REFEREE GRADE _______________________________

YEAR ATTAINED CURRENT GRADE _____________________________

I AM CURRENTLY REGISTERED USSF FOR 2011 YES NO

SDSRA ASSOCIATION DUES PAID 2011? YES NO

I HAVE COMPLETED THE RISK MANAGEMENT REQUIREMENT (18+ YEARS OLD ONLY) YES NO

HOTEL NEEDED? YES NO

ARE YOU CURRENTLY ON THE EMAIL LIST? YES NO

SEND TO LEANNE HARRIS 1227 S. MISSION RD. FALLBROOK, CA 92028

FAX: 760-728-1261