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BRYC REFEREE PROGRAM

All interested referees for the house league,
Referees must be at least 13 years old.
All referees must attend a 2 hour clinic in order to be certified to referee in our house league.
Bring your whistle to the clinic.
The next clinic will be held on Wednesday, June 16th at 6:00 p.m. at Lake Braddock High School Gym.
Please fill out the following 2 forms and bring them to the clinic.
http://www.irs.gov/pub/irs-pdf/fw9.pdf
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BRYC Referee Data Sheet
Last Name_____________________ First Name __________________
Street Address_________________________________________________
City_________________________ State___________ Zip____________
Home Phone___________________ Cellular Phone_________________
E-mail Address_________________________________________________
Emergency Contact Name________________________________________
Emergency Contact Number______________________________________
Referee Experience: 0-1 yr___ 2-3 yrs___ 4-5 yrs___ 5+ yrs___
List Referee Experience (Year - Location - Contact)
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________
5. ___________________________________________________________
Signature__________________________________ Date______________
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