High School Football Officials Camp, LLC

2012 Camper Registration

2012 Camp is SOLD OUT. If you want to be placed on a waiting list in case there are cancelations please register.

Payment Terms:

$350.00 Non-Refundable Deposit is required within 30 days of registration.

or

Payment Options Available
• $50.00 within 10 days of registration
• $50.00 in 45 days after first payment.
• $50.00 in 30 days after second payment
• $100.00 within 30 days of third payment
• $100.00 within 30 days of fourth payment

Balance of $345.00 Due by no later than April 15, 2012.

Payment Options:

• Pay online using VISA/MC or PayPal account
• Send check by mail*

Payment terms:

$350.00 Non-Refundable Deposit is required within 30 days of registration.

or

Payment Options Available
• $50.00 within 10 days of registration
• $50.00 in 45 days after first payment.
• $50.00 in 30 days after second payment
• $100.00 within 30 days of third payment
• $100.00 within 30 days of fourth payment.

Balance of $345.00 Due by no later than April 15, 2012

If sending check, please make check payable to

HS Football Officials Camp, LLC

1609 Sarkesian Drive
Petaluma, CA 94954

* Information Required

* Name:

First Last

* Mailing:

Address

* Mailing:

City State Zip

* Phones:

Home Work Cell

Email:

*Primary

Alternate

* Experience:

First Year

1-3 Years

4+ Years

* Football Association(s) Currently Officiating For:

*Primary Position:

Select the primary position you will be working during the 2012 season.

*Secondary Position:

Sel ect an alternate position you are likely to be working during the 2012 season,
or would like to try out.

Roommate Preference(s):

#1
#2
#3

* Payment Method:

Send Check by Mail

Pay online using VISA/MC or Paypal Account

* Travel Plans:

Drive	Fly	Unknown at this time
if you are traveling by airplane, there will be transportation provided by the HS Camp to and from camp. More details to follow in May

* Emergency Contact(s)

* Primary Contact:		Secondary Contact:
	Name:		Name:
	Phone #1		Phone #1
	Phone #2		Phone #2

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