Spring Season 2012 

Entry Level Soccer Referee 

Certification Clinic – CDA Area 

March 3rd & 4th 

 

Referee Clinic Fees: Clinic=$25.00, USSF Registration=$40.00 

**Please pre-register, to ensure a seat in the class.** 

Location: Bistro on Spruce Restaurant, 1710 N 4th St., Coeur D’Alene, Idaho 

TIMES: Saturday 8:30am to 5:30pm – Sunday 8:30am to 5:30pm 

 FILL OUT REGISTRATION FORM AND MAIL 

 TO: Dave Palmer, 3741 Loxton Loop, CDA ID 83815 

 Questions: send to sdi@idahosoccerrefs.org 

 --------------------------------Tear along line and return lower portion with payment------------------------------------------- 

USSF Entry Level Soccer Referee Certification Clinic 

Registration Form 

CDA Area Clinic – March 3rd & 4th 

Please Print 

 

Name:____________________________________________ Age:_______ 

 

Address:___________________________________________ 

 

City, ST Zip:_______________________________________ 

 

Phone:________________ Email address:_____________________________________ 

 

Clinic fee $25, USSF Registration fee $40. Send form and $65 check or money order to; 

 (Checks should be made out to: “Idaho State Referee Committee” or “ISRC”) 

 

Dave Palmer, 3741 Loxton Loop, CDA, ID 83815 

 

Questions: send to sdi@idahosoccerrefs.org