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Complete Registration Form to Attend the Class

 If you have questions, contact the LYSA Referee Coordinator Tim Brandstetter at lysa.ref.coordinator@gmail.com.  

REGISTRATION FORM

REFEREE CONTACT INFORMATION

Age

PARENT OR GUARDIAN CONTACT INFORMATION (if Referee is under 18 Years)

Do you give permission to the Referee Coordinator to Contact the Referee directly by email or text (applicable only if under 18)
Yes
No. In this case, please make sure you have provide parent contact information

PRIMARY CONTACT

Who is the primary person for the Referee Coordinator to contact for the Referee Class and Scheduling Referee at Games?
Referee
Parent or Guardian
Both

Please enroll me in the upcoming LYSA Referee Class

DIRECTIONS TO SANCTUARY CHURCH

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