To register, simply print and/or fill form below out. Mail check or money order payable (Al Raya) for the amount of $300.00, along with your registration form (non-refundable) before June 1, 2009. After June 1 cost for the camp is $350.00.

Al Raya
Midwest Referee School
5437 N. Sawyer Ave.
Chicago, Illinois 60625

If you have questions regarding the camp, please contact Al Raya at: Home: (773)539-7938
Cell: 312-965-7429
arref @ aol.com

** PLEASE NOTE ALL FIELDS ARE REQUIRED
NAME  
ADDRESS 
CITY
STATE
ZIP CODE 
HOME NUMBER
WORK NUMBER
EMAIL ADDRESS
SHIRT SIZE
Mens or Womens:
I herby release the Midwest Referee School and Clinician Staff, from any and all liability for any injuries or illiness incurred while at the Midwest Referee School. To my knowledge, I do not have any physical impairment that would affect my participation, officiating, in the camp program.

                                              

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