Referee Request for A&B Level Scrimmage Game

Contact: Jim Partlow
d2parts@comcast.net

This year we will be receiving requests for referees for scrimmages via email ONLY. When requesting referees for District two scrimmages, please follow the format listed below. All A & B level scrimmage games are to be emailed using form below one week ahead of the game. Scrimmages requested with less than a 7 day notice will receive an additional charge of $25.00. Cancellations of scrimmages can be made 24 hours prior to the scrimmage but please try to reach Jim in person on these. No cancellations less than 24 hours prior to scrimmage.

Your Name:
Home Number:
Work Number:
Email Address:

Scrimmage Date:		Time:
Arena:		Length of Game :
Home Team:		Visiting Team:
Level:

Head Coach's Name:		Head Coach Phone:

Comments:

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