Please fill out the form and provide your availability for Junior State Champs.

Event Dates: Friday 29th November, Saturday 30th November & Sunday 1st December

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* 1. Please write your first name and last name

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* 2. Please enter your best contact details below:

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* 3. If you are under 18, please provide full name and contact details of a parent or guardian:

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* 4. Which Affiliate will you be representing as a referee?

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* 5. Do you hold a TFA Referee Accreditation? If yes, which level?

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* 6. Do you seek to upgrade to Lv2 or Lv3 Referee Accreditation and gain your next level at the 2024 Junior State Championships?

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* 7. Are you available on Friday, Nov 29th from 6PM to 9:30PM?

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* 8. Are you available on Saturday, Nov 30th? If yes, specify AM, PM or both.

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* 9. Are you available on Sunday, Dec 1st? If yes, specify AM, PM or both.

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* 10. All Accredited Referees will receive a new uniform, please provide your T-SHIRT and SHORTS size below (ie: T-shirt L12 or Medium; Shorts L10 or Men's 38 etc)

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* 11. We are going to provide some food & snacks at the event. Please list any food allergies or requirements below:

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* 12. Please add any comments below:

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