Lake Charles Basketball Association Registration Form
My Signature on this Application Signifies Acceptance of the Following Terms for Application:
First Name *
Your answer
Last Name *
Your answer
SSN *
Last four digits of Social Security Number (example if SSN is 123-45-6789 enter 6789)
Your answer
Cell *
cell phone number including area code
Your answer
Email address *
enter you primary email address that you check frequently
Your answer
Street Address *
Your answer
City *
Your answer
State *
enter La for Louisiana or Tx for Texas
Your answer
Zip *
enter 5 digit zip code
Your answer
Relationships *
Does the association that you are registering with service any school(s) where you have close personal relationships with any players, coaches or faculty members?
Required
Relationship schools
If you answered yes above, please list school where those relationships exist
Your answer
Independant Contractor *
As a Louisiana High School official, it is hereby agreed, stipulated and understood that my work as a high school official is that of an independent contractor and not as an employee of the Louisiana High School Athletic Association, the local officials' association or of the high school districts or high schools competing in an interscholastic athletic competition event. I understand that when I contract as an independent contractor with a high school or local school district to officiate a single competitive athletic event I am being engaged as an independent contractor because of my expertise in officiating this athletic contest, and that I am being engaged to exercise my professional judgement in officiating said competitive athletic event. It is further stipulated and agreed that the game fees for each game(s) officiated will be established by the Louisiana High School Athletic Association according to the applicable rules governing the interscholastic competition for which I have agreed to officiate. I understand that the price for officiating each contest will vary from contest to contest and sport to sport. I hereby agree to officiate the interscholastic competition according to the applicable federation rulebook, as well as any appropriate state adoptions.
Required
Taxes *
It is further stipulated and agreed that my compensation is based upon a lump sum fee for a single competitive event and that no withholdings of these funds are made by the payer. I further acknowledge that as an independent contractor I am solely responsible for paying any and all federal, state, and local income taxes, employer or employee taxes, social security taxes, FICA taxes, Medicare taxes, and any other taxes which may be owed because of the income I earned as an independent contractor.
Required
Agreement *
I hereby declare that I have truthfully answered all parts of this application and any proof of my failure to do so will void my application to become an official with the Louisiana High School Athletic Association. I understand and agree that all of my varsity high school contest assignments will be made through the assignment secretary of my association. I also understand that all assignments are at the sole discretion of the LHSAA and/or the appointed authority . I agree to uphold and observe the constitution, bylaws and assigning regulations of my local association and the LHSAA.
Required
Fees *
It is fully understood and agreed that payment of any/all money to the LHSAA and, the local association does not guarantee or imply any game assignment at any level of play. I also understand that this registration is not complete until all current fees are paid too the LHSAA and the Lake Charles Basketball Officials Association
Required
First Time? *
Is this your first time registering with the LHSAA
Required
Reffered By
If you checked yes in the question above and was influenced by another official to join...What is the name of that official..If none leave blank
Your answer
Verification *
Please type your name below
Your answer
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