2009 Grade 9 Referee Course
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Please enroll me in the clinic on (you must attend both dates):
THIS CLASS IS FULL/CLOSED: Wednesday, June 10 in class and Saturday, June 13 field training
THIS CLASS IS FULL/CLOSED:Wednesday, August 19 in class and Saturday, August 22 field training
Wednesday, August 26 in class and Saturday, August 29 field training
NEW - Adults only (18 up) Tuesday, August 11, Wednesday, August 12 (Field Training) and Thurday, August 13
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Last Name
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First Name
MI
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Street Address:
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City (Due to demand of this course, this course will be limited primarily to San Francisco area including SF, SSF, & Daly City referees or others with demonstrated commitment to serve the Vikings League. 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 (with Viking permission only)
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Zip Code
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Home Phone (xxx)xxx-xxxx
Work Phone (xxx)xxx-xxxx
Cell Phone (xxx)xxx-xxxx
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Email Address
Receive Mass Email?
Check this box -Vikings communicates via email
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Please re-enter email
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Birthdate mm/dd/yy
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Gender
Male
Female
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My Referee Jersey size is:
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
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I understand that space is limited 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 2009 Vikings League. I will be paid for refereeing games. (The reason that Vikings is 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 Viking League games in the Fall of 2009.
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I understand that a minimum of 15 registrants are necessary to avoid cancellation of the course and that space is limited to 25 persons per session. Space is not confirmed until payment has been received. I will mail or deliver my check in the amount of $25.00, payable to "SF Vikings League" along with a COPY of this form to 2521 Judah Street, San Francisco, CA 94122. I will include the name of the referee candidate and clinic start date in the memo portion of the check.
Agree to mail check and copy of this form.
Print TWO Copies of this form. Send one to Vikings with your check and keep one for your records. Shortly after we receive your form and payment we will email you a confirmation that you have been accepted in this course.
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Indicates Response Required