USFF Futsal Referee Certification Registration

2020 USFF Futsal Referee Certification

Class Options for November 2021
Classroom Session + Test
New Referees: 4 Hours
Recertification for 2020/21 USFF Referees: 2 Hours
**Minimum Age 14 by 12/31/21**

What do you need for the class?
Notepaper/Pen
* $60 Check or Cashiers Check payable to PA West
** Self Addressed Stamped Envelope to receive your badge
The below items will need to uploaded to the PA West Affinity system prior to being scheduled your assignments. If you are a returing referee your clearances and Safe Sport must be valid through 12/31/22 to receive your badge.
1.PA State Police Criminal Record Check (PATCH) https://epatch.state. pa.us/

2.PA Child Abuse History Clearance https://www.compass. state.pa.us/cwis/public/home

3.FBI Criminal Background Check https://uenroll. identogo.com/

4.Safe Sport Training: http://safesport.org/ authentication/register?token= ee57337f-31f9-421d-b095- 82fc8c8c4c41

Access Code - YC3E-6P5G-YYIL-CS2M

Class Options:

NEW Referee Classes: 8am - Noon, PISA, Cheswick, PA

Saturday November 13th OR Saturday November 20th (only need to attend 1)

RECERTIFICATION Referee Classes: 6:30pm - 8:30pm, PISA, Cheswick, PA

Friday November 12th OR Friday November 19th (only need to attend 1)
Referee First Name*
Referee Last Name*
Mobile Phone*

Area CodePhone Number
Birthdate

MonthDayYear
Email*
Valid email address for weekly game assignments is REQUIRED
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Class Preference*

Saturday 11/13/21, 8 am - Noon, PISA (NEW)Saturday 11/20/21, 8 am - Noon, PISA (NEW)Friday 11/12/21, 6:30 pm - 8:30 pm, PISA (RECERT)Friday 11/19/21, 6:30 pm - 8:30 pm, PISA (RECERT)
Referee Status*

New USFF Referee - No Prior CertificationRecertifying USFF Referee - Renew for 2022
Experience Level (Outdoor)
Prior Futsal Referee Experience

YesNo
Comments / Preferences
Should be Empty:

2020 USFF Futsal Referee Certification