This form is not collecting results at the moment. BECOME A REFEREE REGISTRATION (CI) (2019-2020) does not collect results after 2019-12-31.


Since there is a referee shortage in the state of Alabama, CI is adopting a “CI Become a Referee” program. If a new referee candidate signs up for the “CI Become a Referee” program, completes the Grade 8 certification and receives the official referee badge, CI will reimburse the candidate $40. In return, the new referee will agree to referee at least 8 CI games in the next 12 months.

Agreement to Referee CI Games:

I agree to referee 8 CI games minimum in the 12 months following the receipt of my referee badge/training certification.

Emergency Contact:

In an emergency, when parent(s) or legal guardian(s) cannot be reached, please contact:

Medical Treatment:

CONSENT FOR MEDICAL TREATMENT (MINOR) – As the referee candidate or parent or legal guardian of the above named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependent.


I, the referee candidate/parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of Club Independent (CI), its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the Club Independent (CI) accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify Club Independent (CI), its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize. In addition – I authorize my or my child’s photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising), television, video, websites, social media, and radio coverage of Club Independent (CI), without compensation.

or cancel