2003 Officials Registration Form

Please Print

Surname: _________________________________

First:        _________________________________

Address: _______________________________________________________
 
                _______________________________________________________
 
                _______________________________________________________

Postal Code: ____________________

Phone: __________________   email:    __________________

Club/School:___________________________

Year Began Officiating: _______________   Citizenship: _________________________

Register me as:

Graded Official:

Interested in officiating at meets, developing and upgrading officiating knowledge

Associate Official:

Available to help at meets occasionally, but do not wish to upgrade

Send a copy of the application and a signed copy of the Informed Consent Agreement to:

ATHLETICS ALBERTA
11759 Groat Road
Edmonton,  AB
T5M 3K6