GAME SUBMISSION FORM
FOR REFEREE USE
REFEREE NAME
*
First Name
Last Name
REFEREE ROLE
*
Please Select
CENTER
ASSISTANT
PAY RATE
ASSIGNOR FEE
GAME CODE
*
LEAGUE
*
Please Select
YSSL
IWSL
NISL
CPSL
NPL
PREMIERSHIP
OTHER
LEAGUE
Enter League Name
HOME TEAM
*
AWAY TEAM
*
HOME TEAM
*
Please Select
CHICAGO BLUES
IPROSKILLS
MIDWAY FC
RIVER FC
RED STAR CHICAGO
O'HARE STRIKERS
WEST LOOP SOCCER CLUB
YOUTH SOCCER INTERNATIONAL
AWAY TEAM
*
Please Select
CHICAGO BLUES
IPROSKILLS
MIDWAY FC
RIVER FC
RED STAR CHICAGO
O'HARE STRIKERS
WEST LOOP SOCCER CLUB
YOUTH SOCCER INTERNATIONAL
AGE GROUP
*
Please Select
U6
U7
U8
U9
U10
U11
U12
U13
U14
U15
U16
U17
U18
U19
GENDER
*
Please Select
GIRLS
BOYS
GAME FORMAT
*
Please Select
5v5
7v7
9v9
11v11
DATE
*
-
Month
-
Day
Year
Date
TIME
*
Hour Minutes
AM
PM
AM/PM Option
HOME TEAM SCORE
*
AWAY TEAM SCORE
*
REFEREE SIGNATURE
*
HOME COACH SIGNATURE
AWAY COACH SIGNATURE
REFEREE ZELLE ACCOUNT (phone # or email address)
*
Enter here phone number or email address associated with your Zelle account.
COMMENTS (OPTIONAL)
Submit
Should be Empty: