TFCUSA Club National Championships 2021

TFCUSA Club National Championships 2021

Official Application

Choccolocco Park Sports Complex
954 Leon Smith Pkwy
Oxford, Alabama

May 22, 2021

Official Application

Questions?
Contact:

Coach Herb Jones
(770) 378-7378
herb@myiathletics.com

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Address:*

Street Address City State / Province / Region Postal / Zip Code

Primary Phone:*

Area Code

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Phone Number

Type:*

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Secondary Phone:

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Phone Number

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Name of Emergency Contact:*

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List any allergies, medications, or medications we should be aware of:

Certification Number/ID:

Please select four (4) areas you would like to work in order of preference (DO NOT select same area for all 4 choices)

Preference 1:*

Preference 2:*

Preference 3:*

Preference 4:*

Please select all the days you will be available:*

Saturday, May 22

How will you be traveling?: *

Air

Car

Other (Explain below)

Other travel arrangements:

Roommate Preference:*

I will not need housing accomodations

Please assign me a roommate

I would like to room with the individual(s) listed below:

Roommate(s) Requested:

Noteworthy Accomplishments:

Please inform us of any special dietary requests.

Request:*

I have no special dietary requests

I am a vegetarian

Other (explain below)

Dietary Explanation

Do you have an athlete or team competing in this event? :*

Yes

No

Please let us know if you have any other special requests or information to share with the officials coordinator:

Please upload a headshot and picture of your officials certification card. File formats accepted (jpg, jpeg, png, gif, doc, docx, xls, xlsx). Max upload 2MB.

Please ensure you have provided an accurate email before submitting your application. This will be the primary form of communication for informing you of your application status.