2018-2019 Southern California Soccer Officials Association OC Chapter Application for Membership

 
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Contact Information
Enter your first name (required).
Enter your last name (required).
Enter your mailing address (required).
Enter the city for your mailing address (required).
Enter the state abbreviation where your mailing address is located (required).
Enter the zip code of the mailing address (required).
Enter your mobile phone # (required).
Please enter an alternate phone number in case we can't reach you on your mobile phone.
Please tell us what other phone # you've given us. (For example: WORK, HOME, MESSAGE, ETC.)
Concussion Management
I attest I have watched an acceptable concussion training video within the last 3 years. Acceptable videos are NFHS, USSF, NISOA, AYSO and CDC.
Type AGREE to indicate your consent and agreement to the concussion management requirements stated above.
History
If you answered "YES", then please provide an explanation.
Signature Area
By signing this application, I am agreeing that I am an independent contractor and voluntary seek to officiate games assigned by the unit. I agree to hold SCSOA-Unit C, its officers and assignors harmless for anything that occurs to me or my property while performing any task related to refereeing soccer matches assigned under the direction of SCSOA-Unit C. I agree to pay the fees required to be a member of the unit and to act professionally at all times while performing the tasks of soccer official. I also understand that continued membership and assignments are conditioned upon my compliance with the ethical and professional standards of the SCSOA and SCSOA-Unit C bylaws. I also understand that I may be dropped from assignments and have my membership terminated by my failure to follow these ethical standards. I attest that I am legally able to work in the United States. I further understand that I am not guaranteed any assignments.
Please type your first and last name to indicate that you are signing this form and certifying that the information you have entered into it is correct and true to the best of your knowledge