Norfolk County Futsal League - Clinic Registration Form

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Norfolk County Futsal League

::: Online Registration for 2008 USFF Referee Clinic:

2008 USFF Referee Clinic is scheduled for 11/18/2007
to be held at the Mansfield Sportsplex
31 Oxford Rd., Mansfield, MA
( fill out this form online & press submit, print out the form confirmation receipt and forward with proper payment to New England Futsal, Att: John Kinnane, 271 Stoney Hollow Rd., Tiverton, RI 02878)

USFF Referee Certification (1 pm to 7 pm)
USFF Referee Re-Certification (5 pm to 7 pm)

::: Clinic Registration: (please scroll using mouse, avoid pressing "Enter" button)

Name:
Street Address:	,
City, State, Zip:	,
Home Phone:
Cell Phone:
Email Address:
Email Confirmation:
# of years officiating soccer:
# of years officiating futsal:
NEF League Affiliated With:
Clinic Selection:

NEF League Available for:

::: Payment Area:

I wish to pay $50. to New England Futsal for a Referee (Re-)Certification Clinic registration & am submitting a copy of payment by mail
I wish to pay $40. to New England Futsal for a Referee (Re-)Certification Clinic & am submitting a copy of my confirmation form and payment by mail

(payment must be received prior to the event and to insure proper payment receipt, please make check payable to New England Futsal & mail along with a copy of your online registration form confirmation receipt to ATT: John Kinnane, 271 Stoney Hollow Rd., Tiverton, RI 02878)