Schiedsrichteranmeldung / Referee registration:

Name:
Strasse / Street:
PLZ / Postal Code:
Ort / Town:
Land / Country:
Geburtsdatum / Date of birth:	(dd/mm/yyyy)
Telefon / Phone:
Email:
Klasse / Level:	1 - National divisions (1st, 2nd, 3rd) 2 - National divisions (lower) 3 - Regional
Sonstige Anmerkungen