UMPIRE MEMBERSHIP APPLICATION

Print out the membership form, fill it out

and mail with payment of $35.00 to:

American Fastpitch Association

2536 Greenacre Ave.

Anaheim, CA 92801

(714) 952-9311

When you register for AFA Umpire Membership you will receive Medical and Liability Insurance, a membership card and an AFA Rule Book.

Thank you for your participation.

State:___________________________

Name:_____________________________________________________________________________________

 

Mailing Address:_____________________________________________________________________________

 

City:____________________________________________State:________________Zip:___________________

 

Home Phone #:(______)_________________________Work Phone #:(______)__________________________

Cell #:(______)________________________________ Fax #: (______)_________________________________

 

E-Mail Address:____________________________________________________________

Number of Years involved in youth sports ____________________

Are you a member of other umpiring associations? __________   If so, please list associations.

___________________________________________________________________________________________

___________________________________________________________________________________________

If you would also like to umpire AFA slowpitch (adult) add $10.00 to your registration fee and write yes. ______

I attest that I am an upstanding citizen of the United States and that I HAVE NOT in the past been involved  in any type of sexual crime.

Signature ____________________________________________________ Date _________________________