HEO Minor - District 4 - Referee Request for APMHA House Exhibition Game
Please use this form for requesting referees for Exhibition Games during the 2018-19 season.
Do Not use this form for regular season games
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REQUESTER INFORMATION
Requestor Type *
Required
Requestor Name *
Requestor e-mail *
Requestor Phone Number *
EXHIBITION GAME INFORMATION
Exhibition Game Date *
REQUEST MUST BE MADE AT A MINIMUM 7 CALENDAR DAYS BEFORE THE GAME
MM
/
DD
/
YYYY
Start Time *
Time
:
Game Duration (including Flood) *
Arena *
Team Age Group *
Level *
Hosting Team Name - Additional Information (if applicable)
e.g. Atom B1
Visitor Team Name *
Do you require a timekeeper/scorekeeper ?   *
There will be additional costs of $20/hour
 GRID FEES, AGREEMENT AND FORM SUBMISSION
Your Hockey Association will be charged in accordance with the following Grid Fees
*
Required
Comments / notes (if applicable)
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