Certified Assignor Registration

REGISTERED ASSIGNER REGISTRATION FORM

The Assigner Registration must be submitted annually with the proper fee.

Attendance required every other year with an online meeting requirement when

face-to-face meetings are not conducted. Registered Assigners are listed on the MHSAA website.

The Assigner Meeting will be held on Sunday, July 28, 2013 from 1:30 pm – 4:30 pm:

at the Amway Grand Hotel, 187 Monroe Ave NW, Grand Rapids.

This year – the $25 Assigner renewal/registration fee will be waived if you attend the Officiate Michigan Day on July 27, 2013 in addition to the Assigner meeting.

THIS FORM IS DUE BY JULY 1, 2013

Please Print Clearly

Name: ______

Address: ______

City: ______Zip: ______

Home #:______Work #:______Cell #: ______

Fax #:______E-Mail Address: ______

REGISTERED MHSAA OFFICIAL: _____Yes ** _____No **MHSAA ID#:______

LEAGUE(S)/CONFERENCE(S) FOR WHICH I AM THE ASSIGNER:

L/C ID # / NAME (Full Name of League/Conference) / SPORT(S)

I AM AN INDEPENDENT ASSIGNER: _____Yes _____No

SPORTS FOR WHICH I ASSIGN:

Baseball

Basketball

Boys Lacrosse

Competitive Cheer

Football

Girls Lacrosse

Gymnastics

Ice Hockey

Soccer

Softball

Swimming

Track/Cross Country

Volleyball

Wrestling

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1661 Ramblewood Drive • East Lansing, MI 48823 • 517-332-5046 • Fax 517-332-4071 • www.mhsaa.com

I UTILIZE A COMPUTER TO ASSIST IN ASSIGNING: _____Yes _____No

IF YES, please identify software you use: ______

ASSIGNERS who are not full-time employees of schools or leagues but are endorsed or appointed by a league, conference or school are required to become MHSAA Registered Assigners in order to perform the assigning service.

ASSIGNER RESOLUTION
Candidate Name (please print):______
I will annually register as an Assigner, attend the every other year in-service or complete the online meeting as the MHSAA schedules, comply with all applicable state, federal and local laws and ordinances and adhere to applicable MHSAA regulations, policies and practices which regard my duties and relationships with officials.
Signature______Date______

By checking this box, I am indicating that I WILL attend BOTH Saturday, July 27th Officiate Michigan Day and Sunday, July 28, 2013 from 1:30 pm – 4:30 pm Assigner Meeting at the Amway Grand Hotel, Grand Rapids.
By checking this box, I am indicating that I WILL ONLY attend Sunday, July 28, 2013 from 1:30 pm – 4:30 pm Assigner Meeting at the Amway Grand Hotel, Grand Rapids. ($25 annual registration fee required)

* Optional Activity- ArbiterFest- 8:00 am-1:00 pm -This will be a drop-in, special ArbiterSports training session in collaboration with this year’s NASO Summit at the Amway Grand Plaza Hotel in Grand Rapids on Sunday, July 28th. ArbiterFest will run from 8:00am to 1:00pm and will cover everything from assigning, evaluations, RefPay, ArbiterGame, question-and-answer opportunities, upcoming features, and more. There is no cost. Breakouts for both seasoned users and newcomers will ensure that everyone expands their use of Arbiter and has a chance to provide feedback. Lunch will be provided and you’ll have an opportunity to meet the new CEO, Jeff Triplette, an active NFL crew chief. (If you know in advance you will be attending ask for the information and a link for you to indicate your interest,

so that they can better plan for the number of attendees)

PLEASE DO NOT FAX THIS MATERIAL

Return to:

MHSAA

1661 Ramblewood Dr

East Lansing, MI 48823

517-332-5046

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1661 Ramblewood Drive • East Lansing, MI 48823 • 517-332-5046 • Fax 517-332-4071 • www.mhsaa.com

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