BRYC REFEREE PROGRAM

All interested referees for the winter house league,

please contact Brian Frazer at bfny30@comcast.net with your requests.

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 winter house league.

Bring your whistle to the clinic.

The next clinic will be held December 19, 2009 at 9:00 a.m. at Poe Middle School Gym 1.

Please fill out the following 2 forms and bring them to the clinic.

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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______________