2025 Northeast Regional Championships -- Referee Application

    
1Complete Form

Option:  

Required  Price: $0.00
Description: Jan. 17-20, Starland Sports Complex, Hanover, Mass.
 = Required Field

 Referee Information

 
 
 
 
RadDatePicker
RadDatePicker
Open the calendar popup.
  AGE GROUP ('24-'25) 
 
 
 Emergency Contact 
 Emergency # 
 Years as a U.S. Soccer licensed futsal referee Required
 Current local futsal league Required
 Current futsal assignor/s Required
 Above-named assignor email address/es Required
 Eldest/highest futsal level regularly officiated? Required
 Did someone invite/recommend you? If so, whom? Required
 Do you request housing? Required
 Do you request transportation from Logan Airport? Required
 Will you be available Friday 1/17? Required
 Will you be available Saturday 1/18? Required
 Will you be available Sunday 1/19? Required
 Will you be available Monday 1/20? 
 What is your Monday availability? Required


 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   


 Refund Policy

 Contact Info