2009/2010 Vikings Referee Grade 8 Clinic
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Please enroll me in the clinic on:
Clinic & Dates TBD
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Last Name
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First Name
MI
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Address:
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City (must be one of the following due to demand of this course, this course will be limited primarily to San Francisco area referees or others with demonstrated commitment to serve the Vikings League. There must be at least 10 applicants to offer this course. The class size is limited to 15 students. In the event that there is extra space, we will open enrollment to residents of other cities):
San Francisco
South San Francisco
Daly City
Other City (request Vikings permission to be on Wait List)
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Zip Code
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Home Phone (xxx)xxx-xxxx
Work Phone (xxx)xxx-xxxx
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Email Address
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Birthdate mm/dd/yy
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Gender
Male
Female
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I understand that space is limited to 15 applicants and by registering for this course I promise to use my best efforts to make sure that I will referee a minimum of 5 games in the Fall 2008 Vikings League. You will be paid for refereeing this game. The reason that we are instituting this requirement is that in the past we have had some people take the course just for general interest and due to space limitations we can not do that any longer.
I promise to referee at least 5 Vikings League games in the Fall of 2008.
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I understand that space is limited to the first 15 paid registered applicants. I will copy and submit payment of $50.00 for this course and mail it to Vikings League located at 2521 Judah Street, SF CA 94122. (Out of District 1 applicants will be waitlisted and notified two days prior to clinic of available space)
I promise to mail a check to Vikings League for $50.00. I will write my name and Grade 8 in the check memo. Out of District 1 should include 'WL' in the memo area.
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I understand that space in this course is limited to 15 persons per session and space is not confirmed until a printout of my online registration has been received at the Vikings office. I will mail a COPY of this form to
SF Vikings League
2521 Judah Street
San Francisco, CA 94122
Agree to mail a copy of this form.
Print TWO Copies of This Form, one to send to us with your check and keep one for your records.
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Indicates Response Required