Smalltown Smackdown 2019 Officials Application

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The Cornfed Derby Dames in Muncie, Indiana will host the second annual Smalltown Smackdown June 22 and 23 at the Delaware County Fairgrounds. This bracketed tournament will feature two days of regulation games between B & C level WFTDA, WFTDA Apprentice, and non-affiliated teams. Tournament head officials will be Shotgun Mike (skating) and Bethly Hallows (non-skating).

*Please note that applications are now closed for referees, but we are still in needs of NSOs*

Thank you for your interest in officiating Smalltown Smackdown. Completing this application does not imply that you have been accepted. Officials will be notified via email regarding acceptance and placement.

Email Address *

Derby Name *

Legal Name *

Phone Number *

Game History Link

Application Link (check all that apply) *

Referee

Non-Skating Official

Required

Desired Positions (check all that apply) *

Head Referee

Inside Pack Ref

Jam Ref

Outside Pack Ref

Head Non-Skating Official

Jam Timer

Penalty Wrangler

Penalty Tracker

Line-up Tracker

Penalty Tracker/Line Up Tracker Combined

Penalty Box Manager

Penalty Box TImer

Scoreboard Operator

Scorekeeper

Required

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Relationship *

Reference #1 Name *

Reference #1 Email Address *

Reference #2 Name *

Reference #2 Email Address *

Medical Conditions or Allergies?

Disclaimer: By clicking "I agree" (1) I confirm that the information provided in this application is correct (2) I understand the description of the position for which I am applying (3) I understand that it is my responsibility to provide transportation for the duration of the event (4) I confirm my availability to attend Smalltown Smackdown. *

I Agree

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