BASIC Referee Companion Session

Please complete the registration form to let the Regional Referee Staff know which session you plan to attend. All sessions will be held at the Jefferson County Community Center. The address for the JCCC is Sam Michael’s Park, 235 Sam Michael’s Lane, Shenandoah Junction, WV 25442.

All students must bring the completion certificates for the Safe Haven and BASIC Referee Courses.

  • Youth or Volunteer
  • Please enter the volunteer's name.
  • Phone number of volunteer or guardian. (Please enter the best phone number to receive important information on class day.)
  • E-mail address of the volunteer or guardian. (This is used to pass along class information.)
  • Please select the session you plan to attend.
  • Please select a size for your referee shirt.
  • Please type the letter that you see in the box. This is a CAPTCHA form to prevent spam.
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