2011/12 Referee Registration
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First Name
MI
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Last Name
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Address
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City
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State
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Zip Code
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Telephone (weekdays)(xxx)xxx-xxxx
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Telephone (nights/weekeends)(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 xx/xx/xx
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Current Age
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License Level
Grade 9
Grade 8
Grade 7
Other (describe)
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I Prefer to Referee (check as many as you want):
U7/8
U9/10
U11small
U12 and up
Other (describe)
After submitting this form, you will be added to our database and we will notify you by email when we post opportunities to referee games in our fall playing league. Games start September 11 and we should be starting to post opportunities around September 7.
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Indicates Response Required