Prior to completing this application you must consider the following Required Commitments - A) Must be 14yrs as of Dec 31-2021 B) Attend on ice evaluation - C) Complete Alliance on-line Clinic D) Attend all day in class clinic - Sept E) Be prepared for Initial start up costs - price of clinic registration and required equipment including Black Helmet and Half Visor CSA - BNQ Neck Guard CSA - Authorized Ref Jersey - Acme Thunder Whistle(2) - Black Pants & Shin Tights - Protective Equipment - Elbow Pads - Shin Pads etc. F) Attend a minimum of 3 hrs of on ice Exhibition Training Games G) Attend Monthly Membership Meetings H) Be available one day every weekend to skate 2 or 3 games (Sept-March) . If you have any questions or comments please send to devprogram@londonrefereesgroup.com

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* 1. I have read and understand the above Preamble

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* 2. Last Name

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* 3. First Name

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* 4. Date of Birth - dd/mm/yyyy

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* 5. E-Mail address

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* 6. Cell Phone#

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* 7. Home Phone - Not same as cell#

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* 8. Home Address - include city and postal code

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* 9. Are you playing hockey

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* 10. If yes - Association and Division

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* 11. Do you work 

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* 12. Would you like to provide a reference

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* 13. I acknowledge as an official of LRG assigned games I am not an employee But I provide my services on a freelance basis

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* 14. I have read and understand the information above

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