PHMSA Referee Course Registration Form

Please fill in the following information and select the appropriate course/session you will be attending. If you have questions, please contact Paul Harmenzon, Director of Referee Instruction.

Name
Address
City
Zip
Home Phone
Work Phone
Mobile Phone
Email 1
Email 2
Are you a youth referee volunteer (under 18)? Yes.

All referees, whether new or returning, need to sign up for training as indicated below.

New referees please sign up for a Basic Referee course. The basic referee course consist of two evening classes and a Saturday or Sunday from 8 to 2 pm. Evening classes are at the Pleasant Hill Community Center in classroom indicated below. The Saturday or Sunday Field Sessions are at Pleasant Hill Middle School.

Basic Class for new Referees

Winter Basic Referee
Basic Referee Basic Referee
Basic Referee Classroom
Basic Referee Field		 Upper Club Room
Upper Club Room
PHMS Field		 Tue 01/15/08 (6:45-9:45 pm)
Thu 01/17/08 (6:45-9:45 pm)
Sun 01/20/08 (8 am to 2 pm)
January '08 Intermediate Upgrade Course McHale Room
McHale Room
PHMS Field		 Tue 01/22/08 (6:45-9:45 pm)
Thu 01/24/08 (6:45-9:45 pm)
Sun 01/27/08(8 am to 2 pm)
January '08 Advanced Upgrade Course Upper Club Room
Upper Club Room
PHMS Field		 Wed 01/23/08 (6:45-9:45 pm)
Fri 01/25/08 (6:45-9:45 pm)
Sun 01/27/08 (8 am to 12 pm)
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