2022 REGISTRATION FORM Please enable JavaScript in your browser to complete this form.Name *FirstLastFirst name and last name are used to create your Formatted Name, as "Last, First". If your first name is Charles and your last name is Smith, your Formatted Name in our roster will be Smith, Charles.Preferred NameIf you go by a Preferred Name instead of your First Name, then your Preferred Name will replace your First Name in our roster. If your first name is Charles and your last name is Smith, but you go by Chuck, your Formatted Name in our roster will be Smith, Chuck.Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome PhoneIf you do not have a home phone number, leave blank.Work PhoneIf you do not have a work phone number, leave blank.Cell PhoneIf you do not have a cell phone number, leave blank.Cell Phone ProviderAT&TBoostConsumer CellularCricketMetroPCSMintSprintT-MobilePatriotVerizonXfinityNoneOtherOther Cell Phone ProviderSmartphone TypeiPhoneAndroidOtherNoneThe type of smartphone you have. If you don't have a smart phone, select None. If you have a smartphone but it's not Apple and not Google Android, select Other. Other Smartphone TypeBirthdate *Use the arrows to position month or year. For quicker setting of year, highlight the year and enter the year directly.Email Address *This email address will be tied to your user name for our website.Alternate Email AddressAlternate e-mail address is for internal use only and will not be published.Alternate PhoneAlternate phone number is for internal use only and will not be published.2022 Season *I plan to officiate in 2022I will be a non-working member in 2022Mark me inactive--I will not be workingArbiter NameThe way your name appears on your Arbiter game schedules. Your Arbiter Name can be found next to your picture in the upper right-hand corner when you're logged into ArbiterSports.com.Paid EvaluatorI would like to be a paid evaluator in 2022RemindersI would like to receive email communicationsI would like text message reminders of upcoming meetingsCrew Chief Positions to apply forVarsity Crew ChiefAlternate Varsity Crew ChiefFreshmen Crew ChiefAlternate Freshmen Crew ChiefVarsity Position (Primary) *RefereeUmpireHead LinesmanLine JudgeBack JudgeVarsity Position (Alternate)RefereeUmpireHead LinesmanLine JudgeBack JudgeFreshmen PositionRefereeUmpireHead LinesmanLine JudgeBack JudgeN/ASelect the position you would like to work for freshmen games, or N/A if you don't want to work freshmen football.Comment or MessageSUBMIT REGISTRATION
