Fill out the form below to register as an Upward League Referee.

Basic Information

FirstName: *

MI:

LastName: *

Address: *

City: *

State: * select...AKALARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWY

Zip: *

EMail: *

DOB: *

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Gender: * select...MaleFemale

Grade to Referee: * select...K51st2nd3rd4th5th6thAll

HomePhone: *

WorkPhone: *

ChurchName: *

Notes:

Additional Information

Have you refereed Upward Basketball before?: *

Yes

No

Are you available to referee multiple games on Saturdays?:

Yes

No

Do you know someone who might be interested in Coaching/Volunteering for Upward this year?

Name:

Phone Number:

Are you a member of a local church?: *

Yes

No

Have you made a personal commitment to Jesus Christ?: *

Yes

No

Please share a little about your relationship with Jesus.: *

Please select the following positions you would also be available to volunteer for::

Prayer partner

Half-Time leader

Score keeper

Concessions

Game-day clean up (after last game)

None (referee only)

I will be attending the Referee training session held on: *

Saturday, January 7 - 8:30 a.m. – 10:00 a.m.

Tuesday, January 10 - 6:30 p.m. – 8:00 p.m. (make-up session)

I understand that any negative personal habits that I have (smoking, alcohol, profanity, etc.) may have a negative affect on a child’s spiritual development.  Understanding that the children on my squad have been placed under my guidance, I commit to setting a worthy behavioral example for them to look to.

Agree/Disagree: *

Yes

No