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PickleCon Referee Registration
Please fill out this form to submit your interest in attending PickleCon and in what capacity of refereeing.
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First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
USA Pickleball Home (Primary) Region
*
Atlantic (CT, MA, ME, NH, RI, VT)
Atlantic South (AL, FL, GA, MS, PR)
Great Lakes (IN, MI, OH)
Mid-Atlantic (DC, KY, MD, NC, SC, TN, VA)
North Mid-Atlantic (DE, NJ, NY, PA, WV)
Great Plains (CO, KS, MT, ND, NE, SD, WY)
Mid-South (AR, LA, OK, TX)
Middle States (IA, IL, MN, MO, WI)
Mountain (NV, UT)
Pacific Northwest (AK, ID, OR, WA)
Southwest (AZ, NM)
West (CA, GU, HI, NMI)
Canada
Other:
Current USA Pickleball Referee Level/Credential
*
New Trainee
USAP Trained
USAP Level 1 Credential
USAP Level 2 Credential
USAP Certified Referee
Purpose for attending PickleCon (check all that apply)
*
Trainer/Mentor
Working Referee
New Referee Training
Current Referee Training/Mentoring
Required
Current USAP Member #
*
Your answer
Roommate Choice #1 (for trainer/mentors and working referees only)
Your answer
Roommate Choice #2 (for trainer/mentors and working referees only)
Your answer
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