Name

First Name

Last Name

Phone

(###)

###

####

How many years and what level of refereeing have you done?

Which leagues would you like to ref?

9U Little Hooper League 2:00pm-2:45pm @ Nu'uanu Elementary -7 games 3/1, 3/8, 3/15, 3/22, 3/29, 4/5, 4/12

9U Little Hooper Sat 2:00pm-2:45pm Nu'uanu Elementary

Will you be able to commit to arriving early to tip off to all 7 games?

Will you be able to find a substitute ref suitable to replace you for any days you cannot attend and notify The League Director a minimum of 24 hrs prior to game day?

List any games you will not be able to ref

Have you been convicted of a crime or is there any circumstance or pattern in your life which would make it inappropriate for you to serve with youth, or would comprise the integrity of TAKI FIT?

If you checked yes, please explain

Do you give TAKI FIT consent to perform a background check?

Terms & Conditions

Waiver & Liability

Agreement

Signature

Date

List any dates you will be missing

YYYY