UMPIRE MEMBERSHIP APPLICATION Fastpitch 2012

Print out the membership form, fill it out

and mail with payment of $40.00 to:

American Fastpitch Association

2926 Calle Frontera

San Clemente, CA 92673

(949) 291-8783  -  (949) 630-3340

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:___________________________Date _______________________

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 _______________________