2025/26 SHA Referee & Timekeeper Application (Sarnia Hockey)

2025/26 SHA Referee & Timekeeper Application

Name^*

Required

Age^*

Required

Date of Birth^*

Required

Preference

Which position(s) are you applying for?^*

RefereeTimekeeper

Check All That Apply

Contact Information

Cell Phone Number^*

Required

Example: ###-###-####

Other Phone Number ie. Home/Parent

Example: ###-###-#### x###

Email Address^*

Required

Example: [email protected]. Your submission will be sent to this address.

Street Address^*

Required

City, Province^*

Required

Postal Code^*

Required

Hockey Background

Please provide information about your hockey experience to-date.

Hockey Background^*

Required

Current or Last Level of Play / Year^*

Required

Why Do You Want to Referee and/or Timekeep?^*

Required

Do You Have Experience Operating Arena Score Clocks?^*

Required

If Yes, Which Arenas?

Clearwater
Pat Stapleton
PASA

Check All That Apply

Reference

Reference Name^*

Required

Address^*

Required

City^*

Required

Postal Code/Zip Code^*

Required

Phone (Home or Cell)^*

Required

Example: ###-###-####

Phone (Business)

Example: ###-###-####

Relation to Applicant^*

Required

2025/26 SHA Referee & Timekeeper Application (Sarnia Hockey)

ALLIANCE HOCKEY Digital Network

Preference

Contact Information

Hockey Background

Reference

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