2025 US Youth Futsal Atlantic Regional Championships -- Referee Application

    
1Complete Form

Option:  

Required  Price: $0.00
Description: January 10-12, 2025 | Manheim, PA
 = Required Field

 Referee Information

 
 
 
 
  Select Month/Day/Year
 
Tell us about yourself 
 If selected, I am available for the following dates: 
 Years as a U.S. Soccer licensed futsal referee Required
 Have you officiated in USYF Nationals Required
 What is your experience with 2-ref system? Required
 Eldest/highest futsal level regularly officiated? Required
 Current futsal assignor/s Required
 Above-named assignor email address/es Required
 Do you request housing? Required
Housing is only available for out of State Referee and Assessors


 Please Confirm

I, the referee or the parent/guardian of the above named referee,  hereby grants to US Youth Futsal and its member clubs and organizations, the right and permission, free from approval, review or cost, to photograph, record or otherwise capture the Referees likeness in participating in the Programs for use in media, now or hereafter known, including, but not limited to pictures and video, to copyright the same in its own name, and which may be included in whole or in part for commercial or promotional use.
By clicking in the adjacent box I hereby certify that I am an active futsal referee, currently officiating in a U.S. Soccer Federation-sanctioned futsal league (as indicated above). I am also current on my futsal referee certification, meaning that I either possess or am waiting for the arrival of a 2021 U.S. Soccer futsal referee badge (or will be taking the 2021 re certification soon).

Your credentials will be verified with your home state's SRA (state referee administrator) and local assignor.


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