(Street, City, State, Zip
Home phone__________________________ Cell phone___________________________
Highest level of officiating___________________________ Years at this level___________
Name of supervisor____________________________________________________________
Supervisor phone number or email address_________________________________________
I understand that Next Level Referee School, Villanova University, and all personnel associated with the camp/school are in no way responsible should I become injured while in attendance or while officiating games. My signature indicates that I agree not to hold any individual or group responsible should an injury occur.
School space is limited and applications will be processed on a first come, first served basis. You will be notified by email of your status as forms and payments are received. More detailed school information and a more in-depth official form will be sent out in a few weeks. Thank you in advance for your interest!
Please include check for $250 made
payable to Next Level Referee School.
Send form and payment to:
Next Level Referee School
20 Grace Court
Swedesboro, NJ 08085.