MEMPHIS CHURCH RECREATION ASSOCIATION

2008 SOCCER REFEREE GAME REPORT

This form must be filled out completely before you will be paid for the games.

 

Name   ____________________________________            PAY SCALE

Address ___________________________________            1^st/ 2^nd grade    $25

City     ____________State_______ Zip__________           3^rd/4^th grade     $25

Telephone _________________________________             5^th/6^th grade     $25

Social Security # ____________________________            7^th/8^th grade     $25

Email address: ______________________________            H. S. Coed      $25

 

GAME #1       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #2       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #3       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #4       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #5       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #6       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #7       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

 

GAME #8       DATE

            ________  _____________________VS__________________________  ______

            AGE           TEAM                  SCORE     TEAM                          SCORE     PAY

If a game is a rainout please designate that and the field on which the game was to be played.  This report must be filled out completely and mailed or faxed to:

                        Mary Ann Wilkerson                          phone 755-5019

                        Advent Presbyterian Church              fax 753-9407

                        1879 North Germantown Road                           TOTAL PAY  ________

                        mwilkerson@adventpres.com