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Chariho Recreation Referee Program
Use this form to sign up if you are interested in becoming a referee in the CYSA recreational program. Please note that you must be at least 12 years old or in the 7th grade to referee in this program.
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Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Date of Birth
*
MM
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DD
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YYYY
Secondary Email Address (optional)
Your answer
Home Address - Street
*
Your answer
Home Address - City
*
Your answer
Home Address - State
*
Rhode Island
Other:
Home Address - Zip
*
Your answer
Primary Phone Number
*
Your answer
Alternate Phone Number
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Are you USSF Certified?
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No
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Additional Comments
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