Name: _______________________________________________________________________

Address: _____________________________________________________________________

City/State/Zip (9 digit zip code): ____________________________________________________

Telephone: ___________________________________________________________________

____________________ Are you interested in working the State Tournaments?

____________________ Are you a new umpire?

Check applicable spaces:

______ Fast Pitch	______ Men
______ Slow Pitch	______ Women
______ Modified	______ Coed
	______ Youth

 

Adult Umpires (over 18 years of age) = $40.00
Youth Umpires (If 18 & Under working youth games only) = $25.00

With this registration, the parties involved consider umpires as Independent Contractors for the duties they perform. Please fill out form completely and submit through league or local organization with proper funding made out to SD ASA and mail to:

South Dakota Amateur Softball Assn. Inc.
P.O. Box 606
Spearfish, SD 57783

This material to be sent to your local league representative whose name and UPS address is as follows: ________________________________________________________________________________________
________________________________________________________________________________________
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