×
Login with your HTGSports account
Email:
Password:
Sign In
Change Password
Logout
2025 Northeast Regional Championships -- Referee Application
1
Complete Form
2
Payment
3
Confirmation
Option:
--Select--
Referee
Price:
$0.00
Description:
Jan. 17-20, Starland Sports Complex, Hanover, Mass.
= Required Field
Referee Information
--Select Player--
GENDER
Please select...
Male
Female
CITY
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
DATE OF BIRTH
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
<<
<
October 2024
>
<<
October 2024
S
M
T
W
T
F
S
40
29
30
1
2
3
4
5
41
6
7
8
9
10
11
12
42
13
14
15
16
17
18
19
43
20
21
22
23
24
25
26
44
27
28
29
30
31
1
2
45
3
4
5
6
7
8
9
AGE GROUP
('24-'25)
Please select...
U10 (2015)
U12 (2013)
U14 (2011)
U16 (2009)
U18 (2007)
Adult
Mobile
SHIRT SIZE
--Select--
YL
AS
AM
AL
AXL
AXXL
Emergency Contact
Emergency #
Years as a U.S. Soccer licensed futsal referee
Current local futsal league
Current futsal assignor/s
Above-named assignor email address/es
Eldest/highest futsal level regularly officiated?
Did someone invite/recommend you? If so, whom?
Do you request housing?
--Select
Yes
No
Do you request transportation from Logan Airport?
--Select
Yes
No
Will you be available Friday 1/17?
--Select
Yes
No
Will you be available Saturday 1/18?
--Select
Yes
No
Will you be available Sunday 1/19?
--Select
Yes
No
Will you be available Monday 1/20?
--Select
Yes
No
What is your Monday availability?
--Select
All Day (til 6)
Leave by 11
Leave by 12
Leave by 1
Leave by 2
Not available
Please Confirm
I, the referee or the parent/guardian of the above named referee, hereby grants to U.S. Youth Futsal and the Massachusetts Futsal Association, 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, and will remain current on my futsal referee certification, meaning that I have receritifed or will soon recertify for 2025.
Please initial here
CONTINUE
Refund Policy
Contact Info
Javascript is required for this website to work correctly but it is turned off on your browser. Please enable it before proceeding.